How much rates vary
Facilitymedian $891 · 10th to 90th $372 to $2,630Professionalmedian $1,585 · 10th to 90th $933 to $2,818
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 $1,000.00 Typical High $2,818.38 | Facility | None | $758.58 | $1,000.00 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,949.84 Typical High $2,818.38 | Professional | None | $933.25 | $1,949.84 | $2,818.38 |
BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $954.99 Median $1,548.82 Typical High $1,621.81 | Professional | None | $954.99 | $1,548.82 | $1,621.81 |
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 $891.25 Median $1,047.13 Typical High $2,511.89 | Professional | None | $891.25 | $1,047.13 | $2,511.89 |
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 $467.74 Median $977.24 Typical High $1,412.54 | Professional | 52 · Reduced service | $467.74 | $977.24 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $389.05 Typical High $575.44 | Professional | 53 · Discontinued | $186.21 | $389.05 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,479.11 Typical High $2,137.96 | Professional | 54 · Surgery only | $691.83 | $1,479.11 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $295.12 Typical High $426.58 | Professional | 55 · Aftercare only | $138.04 | $295.12 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $194.98 Typical High $281.84 | Professional | 56 · Pre-op care only | $93.33 | $194.98 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,380.38 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $645.65 | $1,380.38 | $1,995.26 |
Where Mississippi sits
The same service costs 10.7 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 $17,167MD $1,609
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.