How much rates vary
Facilitymedian $5,248 · 10th to 90th $437 to $6,918Professionalmedian $2,630 · 10th to 90th $2,089 to $14,454
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,162.28 Median $5,495.41 Typical High $9,549.93 | Facility | None | $3,162.28 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $3,235.94 | Professional | None | $2,089.30 | $2,344.23 | $3,235.94 |
BCBS Kansas Setting Facility Modifier None Typical Low $6,456.54 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,456.54 | $6,918.31 | $6,918.31 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $2,041.74 | Facility | None | $446.68 | $676.08 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,818.38 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $4,570.88 | Facility | None | $54.95 | $1,000.00 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $2,089.30 Median $4,168.69 Typical High $14,454.40 | Professional | None | $2,089.30 | $4,168.69 | $14,454.40 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $5,248.07 | Facility | None | $407.38 | $1,000.00 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,995.26 | $2,454.71 | $3,467.37 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,174.90 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,047.13 | $1,174.90 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $467.74 Typical High $645.65 | Professional | 53 · Discontinued | $416.87 | $467.74 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,778.28 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,584.89 | $1,778.28 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $354.81 Typical High $489.78 | Professional | 55 · Aftercare only | $316.23 | $354.81 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $234.42 Typical High $323.59 | Professional | 56 · Pre-op care only | $208.93 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,659.59 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,659.59 | $2,290.87 |
Where Kansas sits
The same service costs 6.9 times more in Maine than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $18,419MD $2,652
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.