How much rates vary
Facilitymedian $955 · 10th to 90th $389 to $3,890Professionalmedian $2,239 · 10th to 90th $1,479 to $2,630
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 $2,238.72 Median $2,290.87 Typical High $2,570.40 | Professional | None | $2,238.72 | $2,290.87 | $2,570.40 |
BCBS Louisiana Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,511.89 | $2,511.89 |
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 $1,584.89 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,584.89 | $1,819.70 | $2,754.23 |
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 $1,318.26 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,698.24 | $2,884.03 |
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 $1,122.02 Median $1,148.15 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,122.02 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $512.86 | Professional | 53 · Discontinued | $446.68 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,737.80 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,698.24 | $1,737.80 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $346.74 Typical High $389.05 | Professional | 55 · Aftercare only | $338.84 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $229.09 Typical High $257.04 | Professional | 56 · Pre-op care only | $223.87 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,621.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,621.81 | $1,778.28 |
Where Louisiana sits
The same service costs 8.2 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 $17,891MD $2,184
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.