How much rates vary
Facilitymedian $912 · 10th to 90th $372 to $2,630Professionalmedian $3,020 · 10th to 90th $1,622 to $5,248
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 $2,818.38 | Facility | None | $758.58 | $1,318.26 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $4,265.80 Typical High $5,248.07 | Professional | None | $1,659.59 | $4,265.80 | $5,248.07 |
BCBS Mississippi Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
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 $1,380.38 Median $2,754.23 Typical High $3,162.28 | Professional | None | $1,380.38 | $2,754.23 | $3,162.28 |
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 $1,659.59 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,659.59 | $1,905.46 | $3,801.89 |
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 $831.76 Median $2,137.96 Typical High $2,630.27 | Professional | 52 · Reduced service | $831.76 | $2,137.96 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $851.14 Typical High $1,047.13 | Professional | 53 · Discontinued | $331.13 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $3,235.94 Typical High $3,981.07 | Professional | 54 · Surgery only | $1,258.93 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $645.65 Typical High $794.33 | Professional | 55 · Aftercare only | $251.19 | $645.65 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $426.58 Typical High $524.81 | Professional | 56 · Pre-op care only | $165.96 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $3,019.95 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $1,174.90 | $3,019.95 | $3,715.35 |
Where Mississippi 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.