How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $5,623Professionalmedian $1,622 · 10th to 90th $1,148 to $3,631
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 $1,122.02 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,288.25 | $1,698.24 |
BCBS Kansas 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 |
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 $1,148.15 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,584.89 | $2,398.83 |
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 $1,202.26 Median $1,412.54 Typical High $8,128.31 | Professional | None | $1,202.26 | $1,412.54 | $8,128.31 |
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 $1,174.90 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,288.25 | $2,089.30 |
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 $645.65 Typical High $851.14 | Professional | 52 · Reduced service | $562.34 | $645.65 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $338.84 | Professional | 53 · Discontinued | $223.87 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $977.24 Typical High $1,258.93 | Professional | 54 · Surgery only | $851.14 | $977.24 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $194.98 Typical High $251.19 | Professional | 55 · Aftercare only | $169.82 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $128.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $112.20 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $912.01 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $794.33 | $912.01 | $1,174.90 |
Where Kansas sits
The same service costs 15.4 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 $28,500MD $1,851
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.