How much rates vary
Facilitymedian $2,754 · 10th to 90th $457 to $6,310Professionalmedian $2,692 · 10th to 90th $1,950 to $16,218
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 $1,288.25 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,288.25 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,995.26 | $2,041.74 | $2,041.74 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,691.53 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $1,258.93 | Facility | None | $549.54 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $3,162.28 | Professional | None | $2,344.23 | $2,818.38 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $3,090.30 Typical High $5,888.44 | Facility | None | $457.09 | $3,090.30 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $16,218.10 | Professional | None | $1,995.26 | $2,691.53 | $16,218.10 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,025.60 | Facility | None | $426.58 | $1,995.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,090.30 | Professional | None | $1,905.46 | $2,344.23 | $3,090.30 |
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 $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,000.00 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $398.11 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Where Oklahoma sits
The same service costs 13.8 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 $35,114TX $2,545
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.