How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,413 · 10th to 90th $1,202 to $3,388
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 $1,412.54 Median $1,412.54 Typical High $1,513.56 | Professional | None | $1,412.54 | $1,412.54 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,071.52 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $3,388.44 | Professional | None | $1,202.26 | $1,318.26 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,819.70 | $1,862.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $3,715.35 | Professional | None | $1,202.26 | $1,412.54 | $3,715.35 |
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 $1,148.15 Median $1,412.54 Typical High $3,715.35 | Professional | None | $1,148.15 | $1,412.54 | $3,715.35 |
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 $707.95 Median $707.95 Typical High $724.44 | Professional | 52 · Reduced service | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $281.84 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,000.00 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $1,000.00 | $1,023.29 |
Where New Jersey sits
The same service costs 8.1 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 $15,945MD $1,975
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.