How much rates vary
Facilitymedian $3,090 · 10th to 90th $537 to $11,220Professionalmedian $1,660 · 10th to 90th $933 to $5,623
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 $676.08 Median $7,943.28 Typical High $21,877.62 | Facility | None | $676.08 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,258.93 | Professional | None | $676.08 | $676.08 | $1,258.93 |
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 $1,230.27 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,659.59 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $4,365.16 | Facility | None | $478.63 | $954.99 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $5,623.41 | Professional | None | $1,071.52 | $1,737.80 | $5,623.41 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,659.59 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,737.80 | $2,187.76 |
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 $1,071.52 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,548.82 | $1,995.26 |
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 $338.84 Median $338.84 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $575.44 |
Where Nebraska sits
The same service costs 12.3 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 $16,849MD $1,375
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.