How much rates vary
Facilitymedian $1,000 · 10th to 90th $389 to $3,890Professionalmedian $2,570 · 10th to 90th $1,738 to $3,020
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 $2,884.03 Typical High $3,890.45 | Facility | None | $676.08 | $2,884.03 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $3,019.95 | Professional | None | $2,454.71 | $2,754.23 | $3,019.95 |
BCBS Louisiana Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,951.21 | $2,951.21 |
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 $1,071.52 Typical High $1,621.81 | Facility | None | $524.81 | $1,071.52 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,819.70 | $2,187.76 | $2,884.03 |
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 $1,584.89 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,584.89 | $2,041.74 | $3,548.13 |
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 $1,230.27 Median $1,380.38 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,230.27 | $1,380.38 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $549.54 Typical High $602.56 | Professional | 53 · Discontinued | $489.78 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,089.30 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,819.70 | $2,089.30 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $416.87 Typical High $457.09 | Professional | 55 · Aftercare only | $363.08 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | 56 · Pre-op care only | $245.47 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,949.84 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,949.84 | $2,089.30 |
Where Louisiana sits
The same service costs 14.4 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 $34,547MD $2,395
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.