How much rates vary
Facilitymedian $2,239 · 10th to 90th $407 to $9,333Professionalmedian $851 · 10th to 90th $708 to $2,042
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 $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,445.44 | Professional | None | $691.83 | $851.14 | $1,445.44 |
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 $758.58 Median $831.76 Typical High $2,089.30 | Professional | None | $758.58 | $831.76 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,148.15 | Professional | None | $812.83 | $1,122.02 | $1,148.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $10,000.00 | Facility | None | $9,549.93 | $9,549.93 | $10,000.00 |
Horizon BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $2,238.72 | Professional | None | $758.58 | $891.25 | $2,238.72 |
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 $707.95 Median $912.01 Typical High $2,398.83 | Professional | None | $707.95 | $912.01 | $2,398.83 |
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 $426.58 Median $426.58 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $630.96 |
Where New Jersey sits
The same service costs 18.7 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 $26,826MD $1,433
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.