How much rates vary
Facilitymedian $891 · 10th to 90th $372 to $2,630Professionalmedian $2,291 · 10th to 90th $1,202 to $3,548
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 $1,202.26 Typical High $2,818.38 | Facility | None | $758.58 | $1,202.26 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $3,548.13 Typical High $3,548.13 | Professional | None | $1,202.26 | $3,548.13 | $3,548.13 |
BCBS Mississippi Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $933.25 Median $2,041.74 Typical High $2,398.83 | Professional | None | $933.25 | $2,041.74 | $2,398.83 |
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 $1,230.27 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,548.82 | $2,818.38 |
7 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 $602.56 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $602.56 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $239.88 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $891.25 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $177.83 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $120.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $831.76 | $2,454.71 | $2,454.71 |
Ambetter Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 62 · Two surgeons | $851.14 | $851.14 | $851.14 |
Where Mississippi 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.