How much rates vary
Facilitymedian $1,820 · 10th to 90th $174 to $7,762Professionalmedian $1,259 · 10th to 90th $1,096 to $8,913
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 $3,715.35 Typical High $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,096.48 | $1,202.26 |
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 $1,258.93 Median $1,348.96 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,348.96 | $2,754.23 |
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 $1,096.48 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,230.27 | $2,187.76 |
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 $1,122.02 Median $1,698.24 Typical High $8,912.51 | Professional | None | $1,122.02 | $1,698.24 | $8,912.51 |
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 $1,096.48 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,258.93 | $2,290.87 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $223.87 | Professional | 53 · Discontinued | $218.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | 54 · Surgery only | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $776.25 |
Where Arizona sits
The same service costs 8.5 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 $16,489MD $1,943
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.