How much rates vary
Facilitymedian $550 · 10th to 90th $389 to $3,467Professionalmedian $1,778 · 10th to 90th $1,202 to $2,188
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 $1,621.81 Median $2,041.74 Typical High $2,187.76 | Professional | None | $1,621.81 | $2,041.74 | $2,187.76 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,905.46 | $2,137.96 |
Christus Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
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 $954.99 Median $1,621.81 Typical High $2,041.74 | Professional | None | $954.99 | $1,621.81 | $2,041.74 |
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 $1,148.15 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,412.54 | $2,344.23 |
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 $851.14 Median $1,023.29 Typical High $1,096.48 | Professional | 52 · Reduced service | $851.14 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $407.38 Typical High $436.52 | Professional | 53 · Discontinued | $338.84 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,513.56 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,288.25 | $1,513.56 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $302.00 Typical High $323.59 | Professional | 55 · Aftercare only | $257.04 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $204.17 Typical High $218.78 | Professional | 56 · Pre-op care only | $169.82 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,412.54 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,412.54 | $1,513.56 |
Where Louisiana sits
The same service costs 12.5 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 $24,646MD $1,975
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.