How much rates vary
Facilitymedian $891 · 10th to 90th $372 to $2,630Professionalmedian $2,291 · 10th to 90th $1,413 to $4,365
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 $1,318.26 Typical High $2,818.38 | Facility | None | $758.58 | $1,318.26 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $3,019.95 Typical High $4,365.16 | Professional | None | $1,445.44 | $3,019.95 | $4,365.16 |
BCBS Mississippi Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $1,445.44 Median $2,344.23 Typical High $2,511.89 | Professional | None | $1,445.44 | $2,344.23 | $2,511.89 |
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 $1,348.96 Median $1,621.81 Typical High $3,801.89 | Professional | None | $1,348.96 | $1,621.81 | $3,801.89 |
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 $724.44 Median $1,513.56 Typical High $2,187.76 | Professional | 52 · Reduced service | $724.44 | $1,513.56 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $602.56 Typical High $891.25 | Professional | 53 · Discontinued | $288.40 | $602.56 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $2,290.87 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,071.52 | $2,290.87 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $457.09 Typical High $660.69 | Professional | 55 · Aftercare only | $213.80 | $457.09 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $302.00 Typical High $436.52 | Professional | 56 · Pre-op care only | $144.54 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $2,137.96 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,000.00 | $2,137.96 | $3,090.30 |
Where Mississippi 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.