How much rates vary
Facilitymedian $692 · 10th to 90th $295 to $3,020Professionalmedian $1,738 · 10th to 90th $1,380 to $3,467
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 $2,089.30 Median $5,495.41 Typical High $9,549.93 | Facility | None | $2,089.30 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,659.59 | $2,089.30 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,230.27 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,819.70 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $660.69 Typical High $2,398.83 | Facility | None | $54.95 | $660.69 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $10,471.29 | Professional | None | $1,348.96 | $1,548.82 | $10,471.29 |
United Setting Facility Modifier None Typical Low $331.13 Median $676.08 Typical High $2,454.71 | Facility | None | $331.13 | $676.08 | $2,454.71 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,548.82 | $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 $295.12 Median $338.84 Typical High $416.87 | Professional | 53 · Discontinued | $295.12 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,258.93 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,096.48 | $1,258.93 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $251.19 Typical High $309.03 | Professional | 55 · Aftercare only | $218.78 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $165.96 Typical High $208.93 | Professional | 56 · Pre-op care only | $144.54 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,174.90 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,174.90 | $1,445.44 |
Where Kansas 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.