How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $10,471Professionalmedian $1,995 · 10th to 90th $1,318 to $2,344
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 $812.83 Median $2,691.53 Typical High $5,248.07 | Facility | None | $812.83 | $2,691.53 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,479.11 | $2,041.74 | $2,290.87 |
Ambetter Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
BCBS Louisiana Setting Facility Modifier None Typical Low $4,265.80 Median $5,128.61 Typical High $12,022.64 | Facility | None | $4,265.80 | $5,128.61 | $12,022.64 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,862.09 | $2,238.72 | $2,238.72 |
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 $1,412.54 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,621.81 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $10,471.29 | Facility | None | $1,202.26 | $2,454.71 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,513.56 | $2,570.40 |
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 $1,000.00 Median $1,023.29 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,000.00 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $457.09 | Professional | 53 · Discontinued | $398.11 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,548.82 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,479.11 | $1,548.82 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $309.03 Typical High $338.84 | Professional | 55 · Aftercare only | $302.00 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $204.17 Typical High $229.09 | Professional | 56 · Pre-op care only | $199.53 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,445.44 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,445.44 | $1,584.89 |
Where Louisiana sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.