How much rates vary
Facilitymedian $2,089 · 10th to 90th $174 to $7,943Professionalmedian $1,230 · 10th to 90th $1,047 to $8,913
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 $5,623.41 Typical High $9,772.37 | Facility | None | $977.24 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,122.02 | $1,412.54 |
BCBS Arizona 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 Arizona Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,995.26 | Professional | None | $912.01 | $977.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,089.30 Typical High $2,691.53 | Facility | None | $630.96 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,122.02 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,122.02 Typical High $6,456.54 | Facility | None | $104.71 | $1,122.02 | $6,456.54 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $8,912.51 | Professional | None | $1,096.48 | $1,659.59 | $8,912.51 |
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 $1,071.52 Median $1,258.93 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,258.93 | $2,238.72 |
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 $562.34 Median $562.34 Typical High $616.60 | Professional | 52 · Reduced service | $562.34 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $912.01 | Professional | 54 · Surgery only | $851.14 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $851.14 |
Where Arizona sits
The same service costs 14.8 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 $28,001MD $1,894
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.