How much rates vary
Facilitymedian $1,585 · 10th to 90th $513 to $11,482Professionalmedian $1,096 · 10th to 90th $851 to $1,820
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 $851.14 Median $1,905.46 Typical High $7,762.47 | Facility | None | $851.14 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,047.13 | Professional | None | $851.14 | $851.14 | $1,047.13 |
BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $13,182.57 Typical High $26,302.68 | Facility | None | $6,165.95 | $13,182.57 | $26,302.68 |
BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,513.56 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,511.89 | Facility | None | $512.86 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,584.89 | Professional | None | $870.96 | $977.24 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $3,235.94 | Professional | None | $851.14 | $1,318.26 | $3,235.94 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,148.15 | Professional | None | $1,000.00 | $1,071.52 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $7,079.46 | Facility | None | $489.78 | $1,258.93 | $7,079.46 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,862.09 | Professional | None | $870.96 | $1,148.15 | $1,862.09 |
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 $426.58 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $676.08 |
Where Illinois sits
The same service costs 11.3 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 $16,690MD $1,474
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.