How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,202 to $10,233Professionalmedian $1,318 · 10th to 90th $1,148 to $11,749
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 $10,715.19 | Facility | None | $977.24 | $6,309.57 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,148.15 | $2,290.87 |
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 $1,230.27 Median $1,318.26 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,318.26 | $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 $1,174.90 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,318.26 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,047.13 | $4,466.84 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $11,748.98 | Professional | None | $1,174.90 | $1,778.28 | $11,748.98 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $6,309.57 Typical High $9,772.37 | Facility | None | $1,096.48 | $6,309.57 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,348.96 | $2,511.89 |
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 $575.44 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | 53 · Discontinued | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $831.76 |
Where Arizona sits
The same service costs 13.5 times more in Maine than in Texas. 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 $34,179TX $2,531
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.