How much rates vary
Facilitymedian $1,413 · 10th to 90th $513 to $3,890Professionalmedian $1,905 · 10th to 90th $1,380 to $12,882
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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,548.82 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,445.44 | $1,445.44 | $1,548.82 |
BCBS Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,737.80 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $2,691.53 | Facility | None | $512.86 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,659.59 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $12,882.50 | Professional | None | $10,964.78 | $10,964.78 | $12,882.50 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,348.96 | $1,621.81 | $3,162.28 |
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 $691.83 Median $758.58 Typical High $1,047.13 | Professional | 52 · Reduced service | $691.83 | $758.58 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $416.87 | Professional | 53 · Discontinued | $275.42 | $302.00 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $316.23 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $208.93 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,479.11 |
Where Tennessee sits
The same service costs 8.0 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 $17,844MD $2,222
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.