How much rates vary
Facilitymedian $1,000 · 10th to 90th $389 to $3,890Professionalmedian $2,692 · 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 $3,019.95 Typical High $4,168.69 | Facility | None | $676.08 | $3,019.95 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $3,162.28 | Professional | None | $2,570.40 | $2,884.03 | $3,162.28 |
BCBS Louisiana Setting Professional Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,511.89 | $3,311.31 | $3,311.31 |
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 $1,905.46 Median $2,344.23 Typical High $3,019.95 | Professional | None | $1,905.46 | $2,344.23 | $3,019.95 |
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 $2,187.76 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,187.76 | $3,630.78 |
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 $1,288.25 Median $1,445.44 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,288.25 | $1,445.44 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $575.44 Typical High $630.96 | Professional | 53 · Discontinued | $512.86 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,187.76 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,905.46 | $2,187.76 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $436.52 Typical High $478.63 | Professional | 55 · Aftercare only | $380.19 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $288.40 Typical High $316.23 | Professional | 56 · Pre-op care only | $257.04 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,041.74 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,041.74 | $2,187.76 |
Where Louisiana sits
The same service costs 14.0 times more in Maine than in Texas. 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 $34,704TX $2,477
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.