How much rates vary
Facilitymedian $891 · 10th to 90th $372 to $2,630Professionalmedian $1,698 · 10th to 90th $891 to $2,630
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 $1,000.00 Typical High $2,630.27 | Facility | None | $758.58 | $1,000.00 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $2,630.27 Typical High $2,630.27 | Professional | None | $891.25 | $2,630.27 | $2,630.27 |
BCBS Mississippi Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $707.95 Median $1,513.56 Typical High $1,778.28 | Professional | None | $707.95 | $1,513.56 | $1,778.28 |
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 $912.01 Median $1,148.15 Typical High $2,041.74 | Professional | None | $912.01 | $1,148.15 | $2,041.74 |
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 $446.68 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $446.68 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $177.83 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $676.08 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $134.90 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $89.13 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $630.96 | $1,862.09 | $1,862.09 |
Where Mississippi sits
The same service costs 10.3 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 $16,837MD $1,634
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.