How much rates vary
Facilitymedian $1,862 · 10th to 90th $174 to $7,943Professionalmedian $1,349 · 10th to 90th $1,175 to $10,965
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 $1,258.93 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,258.93 | $1,862.09 |
BCBS 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 Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,071.52 | $2,238.72 |
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 $1,174.90 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,258.93 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,174.90 Typical High $6,456.54 | Facility | None | $104.71 | $1,174.90 | $6,456.54 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $10,964.78 | Professional | None | $1,230.27 | $1,819.70 | $10,964.78 |
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 $1,202.26 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,380.38 | $2,511.89 |
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 $630.96 Median $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $251.19 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $954.99 |
Where Arizona sits
The same service costs 14.0 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 $28,122MD $2,008
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.