How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $5,623Professionalmedian $1,698 · 10th to 90th $1,349 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 $2,041.74 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,041.74 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,659.59 | $2,041.74 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $2,041.74 | Facility | None | $446.68 | $645.65 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,778.28 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $4,466.84 | Facility | None | $54.95 | $1,000.00 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $21,877.62 | Professional | None | $1,318.26 | $1,513.56 | $21,877.62 |
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 $1,318.26 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,513.56 | $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 $724.44 Median $831.76 Typical High $1,023.29 | Professional | 52 · Reduced service | $724.44 | $831.76 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $331.13 Typical High $407.38 | Professional | 53 · Discontinued | $288.40 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,230.27 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,071.52 | $1,230.27 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $245.47 Typical High $309.03 | Professional | 55 · Aftercare only | $213.80 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $165.96 Typical High $204.17 | Professional | 56 · Pre-op care only | $144.54 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,148.15 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,148.15 | $1,412.54 |
Where Kansas 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.