How much rates vary
Facilitymedian $2,042 · 10th to 90th $174 to $8,511Professionalmedian $1,096 · 10th to 90th $955 to $7,943
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 $977.24 Median $6,309.57 Typical High $9,772.37 | Facility | None | $977.24 | $6,309.57 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,819.70 | Professional | None | $977.24 | $977.24 | $1,819.70 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,659.59 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,981.07 | $10,232.93 |
BCBS Arizona Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $2,137.96 | Professional | None | $977.24 | $1,047.13 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,905.46 | Professional | None | $954.99 | $1,122.02 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,096.48 Typical High $5,128.61 | Facility | None | $104.71 | $1,096.48 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $7,943.28 | Professional | None | $954.99 | $1,445.44 | $7,943.28 |
United Setting Facility Modifier None Typical Low $104.71 Median $1,148.15 Typical High $5,128.61 | Facility | None | $104.71 | $1,148.15 | $5,128.61 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,995.26 | Professional | None | $933.25 | $1,096.48 | $1,995.26 |
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 $489.78 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $758.58 | Professional | 54 · Surgery only | $724.44 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $707.95 |
Where Arizona sits
The same service costs 16.4 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 $28,429MD $1,737
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.