How much rates vary
Facilitymedian $1,820 · 10th to 90th $174 to $7,586Professionalmedian $1,259 · 10th to 90th $1,072 to $21,878
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 $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
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 $954.99 Median $1,023.29 Typical High $2,089.30 | Professional | None | $954.99 | $1,023.29 | $2,089.30 |
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 $1,122.02 Median $1,174.90 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,174.90 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,096.48 Typical High $5,128.61 | Facility | None | $104.71 | $1,096.48 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $21,877.62 | Professional | None | $1,148.15 | $1,698.24 | $21,877.62 |
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 $1,122.02 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,288.25 | $2,344.23 |
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 $588.84 Median $588.84 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $257.04 | Professional | 53 · Discontinued | $234.42 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $954.99 | Professional | 54 · Surgery only | $891.25 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $190.55 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $891.25 |
Where Arizona sits
The same service costs 9.0 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 $17,266MD $1,911
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.