How much rates vary
Facilitymedian $3,090 · 10th to 90th $537 to $18,197Professionalmedian $2,455 · 10th to 90th $1,380 to $8,128
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 $977.24 Median $7,943.28 Typical High $21,877.62 | Facility | None | $977.24 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $2,570.40 | Professional | None | $977.24 | $977.24 | $2,570.40 |
BCBS Nebraska Setting Facility Modifier None Typical Low $12,882.50 Median $16,982.44 Typical High $34,673.69 | Facility | None | $12,882.50 | $16,982.44 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $3,019.95 | Professional | None | $1,819.70 | $2,454.71 | $3,019.95 |
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 $1,548.82 Median $2,511.89 Typical High $8,128.31 | Professional | None | $1,548.82 | $2,511.89 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,995.26 | $2,454.71 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,995.26 | $2,454.71 | $3,311.31 |
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 $1,548.82 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,548.82 | $2,238.72 | $2,884.03 |
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 $489.78 Median $489.78 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $831.76 |
Where Nebraska sits
The same service costs 10.0 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 $17,294MD $1,737
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.