How much rates vary
Facilitymedian $1,950 · 10th to 90th $174 to $7,762Professionalmedian $1,862 · 10th to 90th $1,622 to $13,804
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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $1,862.09 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,862.09 | $1,862.09 | $3,019.95 |
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 $1,621.81 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,621.81 | $1,905.46 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $1,174.90 Typical High $5,128.61 | Facility | None | $104.71 | $1,174.90 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $13,803.84 | Professional | None | $1,621.81 | $2,290.87 | $13,803.84 |
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 $1,621.81 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,621.81 | $1,778.28 | $2,818.38 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,174.90 |
Where Arizona sits
The same service costs 14.0 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 $34,704TX $2,477
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.