How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,514 · 10th to 90th $1,288 to $3,631
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 $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,479.11 | $1,621.81 |
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 $1,288.25 Median $1,412.54 Typical High $3,630.78 | Professional | None | $1,288.25 | $1,412.54 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,905.46 | $1,949.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $3,890.45 | Professional | None | $1,288.25 | $1,513.56 | $3,890.45 |
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 $1,202.26 Median $1,548.82 Typical High $3,981.07 | Professional | None | $1,202.26 | $1,548.82 | $3,981.07 |
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 $741.31 Median $741.31 Typical High $776.25 | Professional | 52 · Reduced service | $741.31 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,096.48 |
Where New Jersey sits
The same service costs 7.5 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 $16,075MD $2,147
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.