How much rates vary
Facilitymedian $1,820 · 10th to 90th $347 to $8,511Professionalmedian $138 · 10th to 90th $123 to $324
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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $239.88 | Professional | None | $131.83 | $134.90 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,023.29 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $338.84 | Professional | None | $125.89 | $134.90 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $186.21 | Professional | None | $131.83 | $181.97 | $186.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $363.08 | Professional | None | $123.03 | $141.25 | $363.08 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $389.05 | Professional | None | $117.49 | $147.91 | $389.05 |
5 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 $67.61 Median $67.61 Typical High $74.13 | Professional | 52 · Reduced service | $67.61 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $29.51 | Professional | 53 · Discontinued | $26.92 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 54 · Surgery only | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $14.79 |
Where New Jersey sits
The same service costs 262.6 times more in Maine than in Montana. 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 $102,516MT $390
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.