How much rates vary
Facilitymedian $5,495 · 10th to 90th $575 to $13,183Professionalmedian $891 · 10th to 90th $661 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 $1,000.00 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,000.00 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $870.96 | Professional | None | $741.31 | $831.76 | $870.96 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,905.46 Median $8,709.64 Typical High $14,791.08 | Facility | None | $1,905.46 | $8,709.64 | $14,791.08 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,412.54 | Professional | None | $741.31 | $1,023.29 | $1,412.54 |
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 $776.25 Median $933.25 Typical High $1,047.13 | Professional | None | $776.25 | $933.25 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,023.29 Typical High $5,888.44 | Facility | None | $398.11 | $1,023.29 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $5,623.41 | Professional | None | $691.83 | $891.25 | $5,623.41 |
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 $645.65 Median $812.83 Typical High $1,202.26 | Professional | None | $645.65 | $812.83 | $1,202.26 |
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 $363.08 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $575.44 |
Where Oklahoma 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.