How much rates vary
Facilitymedian $1,096 · 10th to 90th $407 to $3,890Professionalmedian $1,148 · 10th to 90th $813 to $1,549
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 $724.44 Median $2,511.89 Typical High $3,890.45 | Facility | None | $724.44 | $2,511.89 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,288.25 | Professional | None | $933.25 | $1,122.02 | $1,288.25 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,348.96 | $1,445.44 |
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 $588.84 Median $1,096.48 Typical High $1,348.96 | Professional | None | $588.84 | $1,096.48 | $1,348.96 |
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 $776.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $776.25 | $1,258.93 | $1,737.80 |
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 $467.74 Median $562.34 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $223.87 Typical High $245.47 | Professional | 53 · Discontinued | $190.55 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $851.14 Typical High $912.01 | Professional | 54 · Surgery only | $707.95 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $141.25 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $112.20 Typical High $123.03 | Professional | 56 · Pre-op care only | $93.33 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $794.33 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $660.69 | $794.33 | $851.14 |
Where Louisiana sits
The same service costs 18.7 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 $26,826MD $1,433
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.