How much rates vary
Facilitymedian $1,349 · 10th to 90th $759 to $5,623Professionalmedian $1,445 · 10th to 90th $871 to $2,138
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 $776.25 Median $1,348.96 Typical High $2,818.38 | Facility | None | $776.25 | $1,348.96 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,819.70 Typical High $2,137.96 | Professional | None | $870.96 | $1,819.70 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,258.93 | Professional | None | $794.33 | $794.33 | $1,258.93 |
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 $758.58 Median $1,412.54 Typical High $1,819.70 | Professional | None | $758.58 | $1,412.54 | $1,819.70 |
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 $977.24 Median $1,737.80 Typical High $6,760.83 | Facility | None | $977.24 | $1,737.80 | $6,760.83 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $2,238.72 | Professional | None | $933.25 | $1,047.13 | $2,238.72 |
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 $436.52 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $436.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $173.78 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $660.69 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $131.83 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $87.10 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $616.60 | $1,479.11 | $1,479.11 |
Where Mississippi sits
The same service costs 10.4 times more in Maine than in Texas. 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 $23,768TX $2,290
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.