How much rates vary
Facilitymedian $2,570 · 10th to 90th $501 to $26,303Professionalmedian $1,660 · 10th to 90th $1,175 to $2,239
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 $891.25 Median $3,162.28 Typical High $5,623.41 | Facility | None | $891.25 | $3,162.28 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,621.81 | $1,862.09 |
BCBS Louisiana Setting Facility Modifier None Typical Low $2,290.87 Median $13,803.84 Typical High $33,884.42 | Facility | None | $2,290.87 | $13,803.84 | $33,884.42 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,584.89 | $1,905.46 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $1,584.89 | Facility | None | $524.81 | $1,047.13 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $1,949.84 | Professional | None | $851.14 | $1,584.89 | $1,949.84 |
United Setting Facility Modifier None Typical Low $354.81 Median $724.44 Typical High $4,073.80 | Facility | None | $354.81 | $724.44 | $4,073.80 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,819.70 | $2,454.71 |
5 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 $691.83 Median $812.83 Typical High $891.25 | Professional | 52 · Reduced service | $691.83 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $323.59 Typical High $354.81 | Professional | 53 · Discontinued | $275.42 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,230.27 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,023.29 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $245.47 Typical High $269.15 | Professional | 55 · Aftercare only | $204.17 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $162.18 Typical High $177.83 | Professional | 56 · Pre-op care only | $138.04 | $162.18 | $177.83 |
Where Louisiana sits
The same service costs 15.0 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 $27,402MD $1,821
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.