How much rates vary
Facilitymedian $7,762 · 10th to 90th $417 to $7,762Professionalmedian $1,479 · 10th to 90th $1,122 to $2,512
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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,096.48 Median $1,513.56 Typical High $1,949.84 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,096.48 | $1,513.56 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,202.26 | Facility | None | $446.68 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,348.96 | $2,089.30 |
United Setting Facility Modifier None Typical Low $309.03 Median $575.44 Typical High $2,511.89 | Facility | None | $309.03 | $575.44 | $2,511.89 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,258.93 | $1,949.84 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,737.80 |
Where Alabama sits
The same service costs 13.1 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 $24,687MD $1,882
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.