How much rates vary
Facilitymedian $1,820 · 10th to 90th $174 to $7,762Professionalmedian $1,622 · 10th to 90th $1,349 to $11,482
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 $3,715.35 Typical High $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,479.11 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,778.28 | $1,778.28 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,659.59 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,096.48 Typical High $5,128.61 | Facility | None | $104.71 | $1,096.48 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $11,481.54 | Professional | None | $1,348.96 | $2,398.83 | $11,481.54 |
United Setting Facility Modifier None Typical Low $104.71 Median $1,148.15 Typical High $5,128.61 | Facility | None | $104.71 | $1,148.15 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,513.56 | $2,089.30 |
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 $741.31 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $741.31 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $316.23 | Professional | 53 · Discontinued | $295.12 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,122.02 |
Where Arizona sits
The same service costs 8.1 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 $17,891MD $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.