How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $5,623Professionalmedian $1,445 · 10th to 90th $1,000 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 $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,513.56 | Professional | None | $977.24 | $1,174.90 | $1,513.56 |
BCBS Kansas Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $977.24 Median $1,412.54 Typical High $2,137.96 | Professional | None | $977.24 | $1,412.54 | $2,137.96 |
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 $1,047.13 Median $1,258.93 Typical High $12,302.69 | Professional | None | $1,047.13 | $1,258.93 | $12,302.69 |
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 $1,023.29 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,174.90 | $1,862.09 |
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 $489.78 Median $588.84 Typical High $758.58 | Professional | 52 · Reduced service | $489.78 | $588.84 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $239.88 Typical High $309.03 | Professional | 53 · Discontinued | $194.98 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $891.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $741.31 | $891.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $177.83 Typical High $229.09 | Professional | 55 · Aftercare only | $147.91 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $117.49 Typical High $151.36 | Professional | 56 · Pre-op care only | $97.72 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $831.76 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $691.83 | $831.76 | $1,071.52 |
Where Kansas sits
The same service costs 9.8 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 $16,204MD $1,659
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.