How much rates vary
Facilitymedian $3,631 · 10th to 90th $501 to $14,791Professionalmedian $1,862 · 10th to 90th $1,259 to $2,344
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 $812.83 Median $2,691.53 Typical High $5,248.07 | Facility | None | $812.83 | $2,691.53 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,778.28 | $2,137.96 | $2,344.23 |
BCBS Louisiana Setting Facility Modifier None Typical Low $9,120.11 Median $10,232.93 Typical High $18,197.01 | Facility | None | $9,120.11 | $10,232.93 | $18,197.01 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,698.24 | $1,995.26 | $2,238.72 |
Christus Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $1,584.89 | Facility | None | $524.81 | $1,047.13 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,698.24 | $2,187.76 |
United Setting Facility Modifier None Typical Low $354.81 Median $741.31 Typical High $4,073.80 | Facility | None | $354.81 | $741.31 | $4,073.80 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,548.82 | $2,511.89 |
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 $891.25 Median $1,071.52 Typical High $1,148.15 | Professional | 52 · Reduced service | $891.25 | $1,071.52 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $426.58 Typical High $457.09 | Professional | 53 · Discontinued | $354.81 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,584.89 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,348.96 | $1,584.89 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $316.23 Typical High $338.84 | Professional | 55 · Aftercare only | $269.15 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $213.80 Typical High $229.09 | Professional | 56 · Pre-op care only | $177.83 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,479.11 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,479.11 | $1,584.89 |
Where Louisiana sits
The same service costs 13.9 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 $28,165MD $2,021
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.