How much rates vary
Facilitymedian $4,571 · 10th to 90th $692 to $5,495Professionalmedian $1,318 · 10th to 90th $1,000 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 $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,445.44 | Professional | None | $977.24 | $1,148.15 | $1,445.44 |
BCBS Kansas Setting Facility Modifier None Typical Low $4,570.88 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,570.88 | $4,897.79 | $4,897.79 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $954.99 Median $1,412.54 Typical High $2,089.30 | Professional | None | $954.99 | $1,412.54 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,737.80 Typical High $6,309.57 | Facility | None | $54.95 | $1,737.80 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $7,413.10 | Professional | None | $1,047.13 | $1,230.27 | $7,413.10 |
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 $1,023.29 Median $1,096.48 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,096.48 | $1,862.09 |
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 $489.78 Median $575.44 Typical High $707.95 | Professional | 52 · Reduced service | $489.78 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $229.09 Typical High $288.40 | Professional | 53 · Discontinued | $194.98 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $851.14 Typical High $1,071.52 | Professional | 54 · Surgery only | $724.44 | $851.14 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $169.82 Typical High $213.80 | Professional | 55 · Aftercare only | $147.91 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $114.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $97.72 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $794.33 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $676.08 | $794.33 | $1,000.00 |
Where Kansas sits
The same service costs 10.1 times more in Maine than in Arkansas. 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 $23,736AR $2,352
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.