How much rates vary
Facilitymedian $891 · 10th to 90th $372 to $2,630Professionalmedian $2,239 · 10th to 90th $1,288 to $6,166
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 $758.58 Median $1,318.26 Typical High $2,818.38 | Facility | None | $758.58 | $1,318.26 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $2,951.21 Typical High $6,165.95 | Professional | None | $1,318.26 | $2,951.21 | $6,165.95 |
BCBS Mississippi Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,202.26 | Facility | None | $660.69 | $1,000.00 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $2,187.76 Typical High $2,398.83 | Professional | None | $933.25 | $2,187.76 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $323.59 Median $691.83 Typical High $3,090.30 | Facility | None | $323.59 | $691.83 | $3,090.30 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $3,630.78 | Professional | None | $1,288.25 | $1,584.89 | $3,630.78 |
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 $660.69 Median $1,479.11 Typical High $3,090.30 | Professional | 52 · Reduced service | $660.69 | $1,479.11 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $588.84 Typical High $1,230.27 | Professional | 53 · Discontinued | $263.03 | $588.84 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $2,187.76 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,000.00 | $2,187.76 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $436.52 Typical High $933.25 | Professional | 55 · Aftercare only | $199.53 | $436.52 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $295.12 Typical High $616.60 | Professional | 56 · Pre-op care only | $131.83 | $295.12 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $2,041.74 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $933.25 | $2,041.74 | $4,265.80 |
Where Mississippi sits
The same service costs 7.5 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 $16,075MD $2,147
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.