How much rates vary
Facilitymedian $955 · 10th to 90th $389 to $3,890Professionalmedian $2,188 · 10th to 90th $1,445 to $2,692
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 $1,995.26 Median $2,290.87 Typical High $2,454.71 | Professional | None | $1,995.26 | $2,290.87 | $2,454.71 |
BCBS Louisiana Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,570.40 | Professional | None | $1,949.84 | $2,344.23 | $2,570.40 |
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 $1,148.15 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,862.09 | $2,630.27 |
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 $1,318.26 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,862.09 | $2,951.21 |
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 $1,000.00 Median $1,148.15 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,000.00 | $1,148.15 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $457.09 Typical High $501.19 | Professional | 53 · Discontinued | $398.11 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,698.24 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,513.56 | $1,698.24 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $346.74 Typical High $371.54 | Professional | 55 · Aftercare only | $302.00 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | 56 · Pre-op care only | $199.53 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,584.89 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,584.89 | $1,737.80 |
Where Louisiana sits
The same service costs 15.5 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 $34,449MD $2,222
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.