How much rates vary
Facilitymedian $891 · 10th to 90th $372 to $2,570Professionalmedian $1,738 · 10th to 90th $1,000 to $2,570
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 $2,238.72 | Facility | None | $758.58 | $1,000.00 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,000.00 | $2,238.72 | $2,238.72 |
BCBS Mississippi Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $812.83 Median $1,737.80 Typical High $1,905.46 | Professional | None | $812.83 | $1,737.80 | $1,905.46 |
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 $1,047.13 Median $1,174.90 Typical High $2,818.38 | Professional | None | $1,047.13 | $1,174.90 | $2,818.38 |
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 $501.19 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $501.19 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $199.53 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $758.58 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $151.36 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $100.00 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $707.95 | $1,548.82 | $1,548.82 |
Where Mississippi sits
The same service costs 15.4 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 $28,500MD $1,851
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.