How much rates vary
Facilitymedian $912 · 10th to 90th $372 to $2,630Professionalmedian $2,344 · 10th to 90th $1,259 to $3,715
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 $1,258.93 Typical High $2,818.38 | Facility | None | $758.58 | $1,258.93 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $3,715.35 | Professional | None | $1,258.93 | $3,630.78 | $3,715.35 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
BCBS Mississippi Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
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 $977.24 Median $2,137.96 Typical High $2,511.89 | Professional | None | $977.24 | $2,137.96 | $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 $1,288.25 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,288.25 | $1,659.59 | $2,951.21 |
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 $616.60 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $616.60 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $251.19 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $933.25 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $186.21 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $125.89 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $870.96 | $2,570.40 | $2,570.40 |
Where Mississippi sits
The same service costs 14.0 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 $28,122MD $2,008
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.