How much rates vary
Facilitymedian $3,311 · 10th to 90th $759 to $10,000Professionalmedian $1,862 · 10th to 90th $1,318 to $4,074
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 $2,691.53 Median $6,309.57 Typical High $9,772.37 | Facility | None | $2,691.53 | $6,309.57 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,584.89 | $2,238.72 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $1,318.26 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,862.09 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,398.83 Typical High $9,549.93 | Facility | None | $54.95 | $2,398.83 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $11,748.98 | Professional | None | $1,412.54 | $1,659.59 | $11,748.98 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,302.69 | Facility | None | $933.25 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,548.82 | $2,454.71 |
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 $645.65 Median $794.33 Typical High $1,023.29 | Professional | 52 · Reduced service | $645.65 | $794.33 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $316.23 Typical High $407.38 | Professional | 53 · Discontinued | $263.03 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,202.26 Typical High $1,548.82 | Professional | 54 · Surgery only | $977.24 | $1,202.26 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $239.88 Typical High $309.03 | Professional | 55 · Aftercare only | $194.98 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $204.17 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,122.02 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $912.01 | $1,122.02 | $1,445.44 |
Where Kansas 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.