How much rates vary
Facilitymedian $1,738 · 10th to 90th $437 to $5,754Professionalmedian $2,570 · 10th to 90th $1,862 to $12,882
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 $2,884.03 Median $6,309.57 Typical High $13,182.57 | Facility | None | $2,884.03 | $6,309.57 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,819.70 | $2,238.72 | $2,884.03 |
BCBS Kansas Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $2,041.74 | Facility | None | $446.68 | $645.65 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,570.40 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $2,290.87 Typical High $5,011.87 | Facility | None | $446.68 | $2,290.87 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $12,882.50 | Professional | None | $1,949.84 | $2,344.23 | $12,882.50 |
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 $1,862.09 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,187.76 | $3,019.95 |
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 $912.01 Median $1,122.02 Typical High $1,445.44 | Professional | 52 · Reduced service | $912.01 | $1,122.02 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $446.68 Typical High $575.44 | Professional | 53 · Discontinued | $363.08 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,659.59 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,380.38 | $1,659.59 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $331.13 Typical High $426.58 | Professional | 55 · Aftercare only | $275.42 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $223.87 Typical High $288.40 | Professional | 56 · Pre-op care only | $181.97 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,548.82 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,548.82 | $1,995.26 |
Where Kansas sits
The same service costs 14.4 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 $34,547MD $2,395
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.