How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $5,623Professionalmedian $1,950 · 10th to 90th $1,479 to $3,715
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 $2,238.72 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,238.72 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,819.70 | $2,238.72 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $1,318.26 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,949.84 | $2,884.03 |
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 $1,479.11 Median $1,698.24 Typical High $12,302.69 | Professional | None | $1,479.11 | $1,698.24 | $12,302.69 |
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 $1,445.44 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,698.24 | $2,570.40 |
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 $794.33 Median $912.01 Typical High $1,122.02 | Professional | 52 · Reduced service | $794.33 | $912.01 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $363.08 Typical High $446.68 | Professional | 53 · Discontinued | $316.23 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,348.96 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,174.90 | $1,348.96 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $275.42 Typical High $338.84 | Professional | 55 · Aftercare only | $239.88 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $181.97 Typical High $223.87 | Professional | 56 · Pre-op care only | $158.49 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,258.93 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,258.93 | $1,584.89 |
Where Kansas 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.