How much rates vary
Facilitymedian $3,236 · 10th to 90th $537 to $11,482Professionalmedian $4,365 · 10th to 90th $2,399 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 $1,737.80 Median $7,943.28 Typical High $21,877.62 | Facility | None | $1,737.80 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,737.80 | $2,344.23 |
BCBS Nebraska Setting Facility Modifier None Typical Low $6,165.95 Median $8,128.31 Typical High $16,595.87 | Facility | None | $6,165.95 | $8,128.31 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $4,466.84 Typical High $5,370.32 | Professional | None | $3,235.94 | $4,466.84 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $977.24 Typical High $4,365.16 | Facility | None | $478.63 | $977.24 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $2,754.23 Median $4,570.88 Typical High $14,454.40 | Professional | None | $2,754.23 | $4,570.88 | $14,454.40 |
Midlands Setting Professional Modifier None Typical Low $3,467.37 Median $4,466.84 Typical High $5,888.44 | Professional | None | $3,467.37 | $4,466.84 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $3,467.37 Median $4,365.16 Typical High $5,888.44 | Professional | None | $3,467.37 | $4,365.16 | $5,888.44 |
United Setting Facility Modifier None Typical Low $489.78 Median $891.25 Typical High $3,801.89 | Facility | None | $489.78 | $891.25 | $3,801.89 |
United Setting Professional Modifier None Typical Low $2,754.23 Median $3,981.07 Typical High $5,128.61 | Professional | None | $2,754.23 | $3,981.07 | $5,128.61 |
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 $870.96 Median $870.96 Typical High $1,047.13 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 53 · Discontinued | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $208.93 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,479.11 |
Where Nebraska 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.