How much rates vary
Facilitymedian $3,236 · 10th to 90th $537 to $17,378Professionalmedian $3,890 · 10th to 90th $2,138 to $5,623
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 $1,621.81 Median $7,943.28 Typical High $21,877.62 | Facility | None | $1,621.81 | $7,943.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,884.03 Typical High $4,265.80 | Professional | None | $1,621.81 | $2,884.03 | $4,265.80 |
BCBS Nebraska Setting Facility Modifier None Typical Low $12,022.64 Median $15,848.93 Typical High $32,359.37 | Facility | None | $12,022.64 | $15,848.93 | $32,359.37 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $4,168.69 | Professional | None | $3,235.94 | $3,801.89 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $1,000.00 Typical High $5,011.87 | Facility | None | $489.78 | $1,000.00 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $2,137.96 Median $3,981.07 Typical High $12,882.50 | Professional | None | $2,137.96 | $3,981.07 | $12,882.50 |
Midlands Setting Professional Modifier None Typical Low $3,235.94 Median $3,981.07 Typical High $5,248.07 | Professional | None | $3,235.94 | $3,981.07 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $2,951.21 Median $4,073.80 Typical High $5,623.41 | Professional | None | $2,951.21 | $4,073.80 | $5,623.41 |
United Setting Facility Modifier None Typical Low $489.78 Median $891.25 Typical High $3,801.89 | Facility | None | $489.78 | $891.25 | $3,801.89 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $4,897.79 | Professional | None | $2,137.96 | $3,467.37 | $4,897.79 |
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 $812.83 Median $812.83 Typical High $1,445.44 | Professional | 52 · Reduced service | $812.83 | $812.83 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $575.44 | Professional | 53 · Discontinued | $323.59 | $323.59 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $426.58 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $288.40 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,995.26 |
Where Nebraska 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.