How much rates vary
Facilitymedian $1,175 · 10th to 90th $257 to $7,943Professionalmedian $1,445 · 10th to 90th $1,096 to $4,169
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 $2,398.83 Median $6,918.31 Typical High $13,803.84 | Facility | None | $2,398.83 | $6,918.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,258.93 | $1,659.59 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $1,096.48 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,548.82 | $2,187.76 |
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 $1,122.02 Median $1,258.93 Typical High $7,943.28 | Professional | None | $1,122.02 | $1,258.93 | $7,943.28 |
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 $1,096.48 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,230.27 | $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 $537.03 Median $630.96 Typical High $831.76 | Professional | 52 · Reduced service | $537.03 | $630.96 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $251.19 Typical High $331.13 | Professional | 53 · Discontinued | $218.78 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $954.99 Typical High $1,230.27 | Professional | 54 · Surgery only | $812.83 | $954.99 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $190.55 Typical High $245.47 | Professional | 55 · Aftercare only | $162.18 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $125.89 Typical High $165.96 | Professional | 56 · Pre-op care only | $109.65 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $891.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $758.58 | $891.25 | $1,148.15 |
Where Kansas 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.