How much rates vary
Facilitymedian $1,995 · 10th to 90th $417 to $10,000Professionalmedian $1,622 · 10th to 90th $1,380 to $3,715
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 $1,621.81 Median $8,511.38 Typical High $12,882.50 | Facility | None | $1,621.81 | $8,511.38 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,621.81 | $2,754.23 |
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 $1,445.44 Median $1,584.89 Typical High $3,981.07 | Professional | None | $1,445.44 | $1,584.89 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $2,187.76 | Professional | None | $1,621.81 | $2,137.96 | $2,187.76 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $4,265.80 | Professional | None | $1,445.44 | $1,698.24 | $4,265.80 |
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 $1,348.96 Median $1,737.80 Typical High $4,570.88 | Professional | None | $1,348.96 | $1,737.80 | $4,570.88 |
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 $812.83 Median $812.83 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $169.82 |
Where New Jersey sits
The same service costs 24.1 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 $53,525MD $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.