How much rates vary
Facilitymedian $1,820 · 10th to 90th $174 to $7,586Professionalmedian $1,413 · 10th to 90th $1,202 to $12,303
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 $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $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 $1,047.13 Median $1,122.02 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,122.02 | $2,290.87 |
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 $1,230.27 Median $1,288.25 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,288.25 | $2,454.71 |
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 $1,288.25 Median $1,905.46 Typical High $12,302.69 | Professional | None | $1,288.25 | $1,905.46 | $12,302.69 |
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 $1,230.27 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,445.44 | $2,630.27 |
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 $645.65 Median $645.65 Typical High $707.95 | Professional | 52 · Reduced service | $645.65 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,047.13 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $977.24 |
Where Arizona sits
The same service costs 12.0 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 $24,859MD $2,076
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.