How much rates vary
Facilitymedian $2,042 · 10th to 90th $575 to $6,761Professionalmedian $1,585 · 10th to 90th $1,148 to $2,884
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 $1,949.84 Median $4,677.35 Typical High $9,549.93 | Facility | None | $1,949.84 | $4,677.35 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,318.26 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $2,041.74 | Facility | None | $446.68 | $676.08 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,659.59 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,778.28 Typical High $6,309.57 | Facility | None | $54.95 | $1,778.28 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $8,511.38 | Professional | None | $1,230.27 | $1,445.44 | $8,511.38 |
United Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $6,760.83 | Facility | None | $691.83 | $2,187.76 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,288.25 | $2,187.76 |
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 $562.34 Median $660.69 Typical High $831.76 | Professional | 52 · Reduced service | $562.34 | $660.69 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $263.03 Typical High $331.13 | Professional | 53 · Discontinued | $229.09 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,000.00 Typical High $1,258.93 | Professional | 54 · Surgery only | $851.14 | $1,000.00 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $199.53 Typical High $251.19 | Professional | 55 · Aftercare only | $169.82 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $131.83 Typical High $165.96 | Professional | 56 · Pre-op care only | $114.82 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $933.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $794.33 | $933.25 | $1,174.90 |
Where Kansas sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.