How much rates vary
Facilitymedian $759 · 10th to 90th $331 to $2,884Professionalmedian $186 · 10th to 90th $112 to $339
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 $112.20 Median $891.25 Typical High $1,995.26 | Facility | None | $112.20 | $891.25 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $234.42 Typical High $338.84 | Professional | None | $112.20 | $234.42 | $338.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $56.23 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $22.39 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $173.78 Typical High $257.04 | Professional | 54 · Surgery only | $83.18 | $173.78 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $16.60 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $11.22 | $23.44 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
BCBS Mississippi Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $758.58 Typical High $1,737.80 | Facility | None | $588.84 | $758.58 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $199.53 | Professional | None | $120.23 | $186.21 | $199.53 |
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 $109.65 Median $125.89 Typical High $309.03 | Professional | None | $109.65 | $125.89 | $309.03 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 80 · Assistant surgeon | $18.20 | $18.20 | $18.20 |
Where Mississippi sits
The same service costs 44.0 times more in Maine than in Montana. 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 $16,369MT $372
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.