How much rates vary
Facilitymedian $1,738 · 10th to 90th $794 to $5,754Professionalmedian $2,138 · 10th to 90th $1,288 to $3,981
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 $776.25 Median $1,174.90 Typical High $2,884.03 | Facility | None | $776.25 | $1,174.90 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $2,691.53 Typical High $3,981.07 | Professional | None | $1,288.25 | $2,691.53 | $3,981.07 |
Ambetter Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
BCBS Mississippi Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,288.25 Median $2,089.30 Typical High $2,238.72 | Professional | None | $1,288.25 | $2,089.30 | $2,238.72 |
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 $1,122.02 Median $2,290.87 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,290.87 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $3,388.44 | Professional | None | $1,230.27 | $1,445.44 | $3,388.44 |
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 $645.65 Median $1,348.96 Typical High $1,949.84 | Professional | 52 · Reduced service | $645.65 | $1,348.96 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $537.03 Typical High $794.33 | Professional | 53 · Discontinued | $257.04 | $537.03 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $2,041.74 Typical High $2,951.21 | Professional | 54 · Surgery only | $954.99 | $2,041.74 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $407.38 Typical High $588.84 | Professional | 55 · Aftercare only | $190.55 | $407.38 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $269.15 Typical High $398.11 | Professional | 56 · Pre-op care only | $128.82 | $269.15 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,905.46 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $891.25 | $1,905.46 | $2,754.23 |
Where Mississippi 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.