How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,862 · 10th to 90th $1,585 to $4,467
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 $1,819.70 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,819.70 | $1,819.70 | $1,995.26 |
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 $1,584.89 Median $1,698.24 Typical High $4,466.84 | Professional | None | $1,584.89 | $1,698.24 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $2,454.71 | Professional | None | $1,698.24 | $2,344.23 | $2,454.71 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $4,786.30 | Professional | None | $1,584.89 | $1,862.09 | $4,786.30 |
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 $1,479.11 Median $1,862.09 Typical High $4,897.79 | Professional | None | $1,479.11 | $1,862.09 | $4,897.79 |
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 $891.25 Median $891.25 Typical High $954.99 | Professional | 52 · Reduced service | $891.25 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $380.19 | Professional | 53 · Discontinued | $363.08 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,348.96 |
Where New Jersey sits
The same service costs 7.1 times more in Maine than in Washington. 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 $16,524WA $2,342
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.