How much rates vary
Facilitymedian $3,090 · 10th to 90th $537 to $11,482Professionalmedian $3,548 · 10th to 90th $1,862 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 $1,412.54 Median $7,943.28 Typical High $21,877.62 | Facility | None | $1,412.54 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,412.54 | $3,162.28 |
BCBS Nebraska Setting Facility Modifier None Typical Low $6,456.54 Median $8,709.64 Typical High $17,782.79 | Facility | None | $6,456.54 | $8,709.64 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,548.13 Typical High $4,365.16 | Professional | None | $2,630.27 | $3,548.13 | $4,365.16 |
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 $2,187.76 Median $3,630.78 Typical High $11,481.54 | Professional | None | $2,187.76 | $3,630.78 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $2,818.38 Median $3,548.13 Typical High $4,677.35 | Professional | None | $2,818.38 | $3,548.13 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $2,818.38 Median $3,548.13 Typical High $4,677.35 | Professional | None | $2,818.38 | $3,548.13 | $4,677.35 |
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 $2,187.76 Median $3,235.94 Typical High $4,168.69 | Professional | None | $2,187.76 | $3,235.94 | $4,168.69 |
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 $707.95 Median $707.95 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,174.90 |
Where Nebraska 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.