How much rates vary
Facilitymedian $955 · 10th to 90th $389 to $3,890Professionalmedian $2,630 · 10th to 90th $1,820 to $3,311
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 $2,951.21 Typical High $3,890.45 | Facility | None | $676.08 | $2,951.21 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $3,090.30 | Professional | None | $2,511.89 | $2,818.38 | $3,090.30 |
BCBS Louisiana Setting Professional Modifier None Typical Low $2,398.83 Median $2,884.03 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,884.03 | $3,162.28 |
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 $1,412.54 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,412.54 | $2,290.87 | $3,235.94 |
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 $1,698.24 Median $2,290.87 Typical High $3,715.35 | Professional | None | $1,698.24 | $2,290.87 | $3,715.35 |
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 $1,258.93 Median $1,412.54 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,258.93 | $1,412.54 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $562.34 Typical High $616.60 | Professional | 53 · Discontinued | $501.19 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,137.96 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,862.09 | $2,137.96 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $426.58 Typical High $457.09 | Professional | 55 · Aftercare only | $371.54 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $281.84 Typical High $309.03 | Professional | 56 · Pre-op care only | $251.19 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,995.26 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,995.26 | $2,137.96 |
Where Louisiana sits
The same service costs 13.4 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 $34,930MD $2,604
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.