How much rates vary
Facilitymedian $891 · 10th to 90th $372 to $2,630Professionalmedian $2,754 · 10th to 90th $1,820 to $5,623
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 $1,862.09 Median $3,890.45 Typical High $5,623.41 | Professional | None | $1,862.09 | $3,890.45 | $5,623.41 |
BCBS Mississippi Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 $1,862.09 Median $3,019.95 Typical High $3,235.94 | Professional | None | $1,862.09 | $3,019.95 | $3,235.94 |
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 $1,778.28 Median $2,089.30 Typical High $4,897.79 | Professional | None | $1,778.28 | $2,089.30 | $4,897.79 |
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 $912.01 Median $1,949.84 Typical High $2,818.38 | Professional | 52 · Reduced service | $912.01 | $1,949.84 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $776.25 Typical High $1,122.02 | Professional | 53 · Discontinued | $371.54 | $776.25 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,884.03 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,380.38 | $2,884.03 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $588.84 Typical High $851.14 | Professional | 55 · Aftercare only | $275.42 | $588.84 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $389.05 Typical High $562.34 | Professional | 56 · Pre-op care only | $186.21 | $389.05 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,691.53 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,691.53 | $3,981.07 |
Where Mississippi sits
The same service costs 6.9 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 $18,419MD $2,652
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.