How much rates vary
Facilitymedian $1,778 · 10th to 90th $447 to $10,233Professionalmedian $1,905 · 10th to 90th $1,479 to $3,631
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 $2,884.03 Median $6,456.54 Typical High $10,964.78 | Facility | None | $2,884.03 | $6,456.54 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,778.28 | $2,187.76 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $1,778.28 | Facility | None | $602.56 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,905.46 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,905.46 Typical High $10,232.93 | Facility | None | $446.68 | $1,905.46 | $10,232.93 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $11,481.54 | Professional | None | $1,445.44 | $1,698.24 | $11,481.54 |
United Setting Facility Modifier None Typical Low $407.38 Median $1,000.00 Typical High $5,248.07 | Facility | None | $407.38 | $1,000.00 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,659.59 | $2,454.71 |
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 $758.58 Median $870.96 Typical High $1,096.48 | Professional | 52 · Reduced service | $758.58 | $870.96 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $354.81 Typical High $436.52 | Professional | 53 · Discontinued | $309.03 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,318.26 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,148.15 | $1,318.26 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $263.03 Typical High $323.59 | Professional | 55 · Aftercare only | $229.09 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $177.83 Typical High $218.78 | Professional | 56 · Pre-op care only | $154.88 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,230.27 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,230.27 | $1,513.56 |
Where Kansas sits
The same service costs 13.9 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 $28,165MD $2,021
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.