How much rates vary
Facilitymedian $955 · 10th to 90th $389 to $3,890Professionalmedian $1,778 · 10th to 90th $1,202 to $2,239
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 $676.08 Median $2,691.53 Typical High $3,890.45 | Facility | None | $676.08 | $2,691.53 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,041.74 | Professional | None | $1,659.59 | $1,862.09 | $2,041.74 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,905.46 | $2,089.30 |
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 $1,621.81 | Facility | None | $524.81 | $1,047.13 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,137.96 | Professional | None | $933.25 | $1,513.56 | $2,137.96 |
United Setting Facility Modifier None Typical Low $354.81 Median $724.44 Typical High $4,073.80 | Facility | None | $354.81 | $724.44 | $4,073.80 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,548.82 | $2,454.71 |
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 $831.76 Median $933.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $831.76 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $380.19 Typical High $407.38 | Professional | 53 · Discontinued | $331.13 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,412.54 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,412.54 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $281.84 Typical High $309.03 | Professional | 55 · Aftercare only | $245.47 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $186.21 Typical High $204.17 | Professional | 56 · Pre-op care only | $165.96 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,318.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,318.26 | $1,412.54 |
Where Louisiana sits
The same service costs 8.5 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 $16,489MD $1,943
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.