How much rates vary
Facilitymedian $1,738 · 10th to 90th $437 to $5,754Professionalmedian $2,692 · 10th to 90th $1,950 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 $3,019.95 Median $6,309.57 Typical High $13,182.57 | Facility | None | $3,019.95 | $6,309.57 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $3,019.95 | Professional | None | $1,949.84 | $2,344.23 | $3,019.95 |
BCBS Kansas Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $1,995.26 Median $3,235.94 Typical High $3,235.94 | Professional | None | $1,995.26 | $3,235.94 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $2,398.83 Typical High $5,011.87 | Facility | None | $446.68 | $2,398.83 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $13,803.84 | Professional | None | $2,041.74 | $2,454.71 | $13,803.84 |
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 $1,949.84 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,949.84 | $2,290.87 | $3,162.28 |
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 $977.24 Median $1,174.90 Typical High $1,513.56 | Professional | 52 · Reduced service | $977.24 | $1,174.90 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $467.74 Typical High $602.56 | Professional | 53 · Discontinued | $389.05 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,778.28 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,445.44 | $1,778.28 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $354.81 Typical High $457.09 | Professional | 55 · Aftercare only | $288.40 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $234.42 Typical High $302.00 | Professional | 56 · Pre-op care only | $194.98 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,659.59 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,659.59 | $2,137.96 |
Where Kansas 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.