How much rates vary
Facilitymedian $2,138 · 10th to 90th $407 to $10,715Professionalmedian $1,259 · 10th to 90th $1,096 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 $4,466.84 Median $10,471.29 Typical High $14,791.08 | Facility | None | $4,466.84 | $10,471.29 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,202.26 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $3,235.94 | Facility | None | $1,023.29 | $2,137.96 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,174.90 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,659.59 | $1,698.24 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $3,235.94 | Professional | None | $1,096.48 | $1,288.25 | $3,235.94 |
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 $1,023.29 Median $1,288.25 Typical High $3,467.37 | Professional | None | $1,023.29 | $1,288.25 | $3,467.37 |
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 $602.56 Median $602.56 Typical High $645.65 | Professional | 52 · Reduced service | $602.56 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | 53 · Discontinued | $239.88 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | 54 · Surgery only | $912.01 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $131.83 |
Where New Jersey sits
The same service costs 15.0 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 $27,402MD $1,821
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.