How much rates vary
Facilitymedian $851 · 10th to 90th $372 to $2,570Professionalmedian $1,122 · 10th to 90th $676 to $2,188
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 $691.83 Median $1,000.00 Typical High $2,187.76 | Facility | None | $691.83 | $1,000.00 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $2,187.76 Typical High $2,187.76 | Professional | None | $691.83 | $2,187.76 | $2,187.76 |
BCBS Mississippi Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
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 $537.03 Median $1,096.48 Typical High $1,380.38 | Professional | None | $537.03 | $1,096.48 | $1,380.38 |
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 $676.08 Median $831.76 Typical High $1,819.70 | Professional | None | $676.08 | $831.76 | $1,819.70 |
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 $346.74 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $346.74 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $138.04 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $512.86 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $102.33 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $69.18 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $478.63 | $1,513.56 | $1,513.56 |
Where Mississippi sits
The same service costs 11.3 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 $15,814MD $1,394
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.