How much rates vary
Facilitymedian $955 · 10th to 90th $389 to $3,890Professionalmedian $1,778 · 10th to 90th $1,148 to $2,089
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 $676.08 Median $2,691.53 Typical High $3,890.45 | Facility | None | $676.08 | $2,691.53 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,778.28 | $1,819.70 | $1,995.26 |
BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,995.26 | $1,995.26 |
Christus Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $1,621.81 | Facility | None | $524.81 | $1,047.13 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,445.44 | $2,187.76 |
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 $1,023.29 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,288.25 | $2,238.72 |
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 $870.96 Median $912.01 Typical High $1,000.00 | Professional | 52 · Reduced service | $870.96 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $407.38 | Professional | 53 · Discontinued | $354.81 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,348.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,318.26 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $269.15 Typical High $302.00 | Professional | 55 · Aftercare only | $263.03 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $181.97 Typical High $199.53 | Professional | 56 · Pre-op care only | $177.83 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,258.93 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,258.93 | $1,412.54 |
Where Louisiana sits
The same service costs 9.4 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 $17,434MD $1,851
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.