How much rates vary
Facilitymedian $6,310 · 10th to 90th $562 to $13,804Professionalmedian $1,905 · 10th to 90th $1,380 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 $1,288.25 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,288.25 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,737.80 | $1,995.26 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $6,025.60 Median $10,000.00 Typical High $15,488.17 | Facility | None | $6,025.60 | $10,000.00 | $15,488.17 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,548.82 | $2,089.30 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $1,258.93 | Facility | None | $549.54 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,905.46 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $2,238.72 Typical High $6,309.57 | Facility | None | $398.11 | $2,238.72 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $11,481.54 | Professional | None | $1,412.54 | $1,862.09 | $11,481.54 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,025.60 | Facility | None | $426.58 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,659.59 | $2,454.71 |
7 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 $758.58 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $309.03 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,202.26 | $1,202.26 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $302.00 | $302.00 |
Where Oklahoma 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.