How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $5,623Professionalmedian $1,230 · 10th to 90th $912 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 $1,905.46 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,905.46 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,445.44 | Professional | None | $912.01 | $1,122.02 | $1,445.44 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $912.01 Median $1,288.25 Typical High $1,905.46 | Professional | None | $912.01 | $1,288.25 | $1,905.46 |
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 $891.25 Median $1,096.48 Typical High $7,079.46 | Professional | None | $891.25 | $1,096.48 | $7,079.46 |
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 $891.25 Median $1,071.52 Typical High $1,737.80 | Professional | None | $891.25 | $1,071.52 | $1,737.80 |
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 $457.09 Median $549.54 Typical High $707.95 | Professional | 52 · Reduced service | $457.09 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $223.87 Typical High $288.40 | Professional | 53 · Discontinued | $181.97 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $831.76 Typical High $1,071.52 | Professional | 54 · Surgery only | $691.83 | $831.76 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $165.96 Typical High $213.80 | Professional | 55 · Aftercare only | $138.04 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $112.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $91.20 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $776.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $645.65 | $776.25 | $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 $16,050AR $1,584
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.