How much rates vary
Facilitymedian $891 · 10th to 90th $372 to $2,884Professionalmedian $6,166 · 10th to 90th $3,388 to $10,715
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 $1,318.26 Typical High $3,388.44 | Facility | None | $758.58 | $1,318.26 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $10,715.19 Typical High $10,715.19 | Professional | None | $3,388.44 | $10,715.19 | $10,715.19 |
BCBS Mississippi Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
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 $2,630.27 Median $5,623.41 Typical High $6,918.31 | Professional | None | $2,630.27 | $5,623.41 | $6,918.31 |
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 $3,388.44 Median $4,265.80 Typical High $9,332.54 | Professional | None | $3,388.44 | $4,265.80 | $9,332.54 |
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 $1,698.24 Median $5,370.32 Typical High $5,370.32 | Professional | 52 · Reduced service | $1,698.24 | $5,370.32 | $5,370.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $2,137.96 Typical High $2,137.96 | Professional | 53 · Discontinued | $676.08 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $8,128.31 Typical High $8,128.31 | Professional | 54 · Surgery only | $2,570.40 | $8,128.31 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $1,621.81 Typical High $1,621.81 | Professional | 55 · Aftercare only | $512.86 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $1,071.52 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $338.84 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $7,585.78 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $2,398.83 | $7,585.78 | $7,585.78 |
Where Mississippi sits
The same service costs 9.9 times more in Maine than in Washington. 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 $37,607WA $3,801
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.