How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,288 · 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 $4,365.16 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 $1,288.25 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,288.25 | $2,137.96 |
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 $1,122.02 Median $1,202.26 Typical High $3,090.30 | Professional | None | $1,122.02 | $1,202.26 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,659.59 | $1,698.24 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $3,388.44 | Professional | None | $1,096.48 | $1,288.25 | $3,388.44 |
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 $1,047.13 Median $1,318.26 Typical High $3,467.37 | Professional | None | $1,047.13 | $1,318.26 | $3,467.37 |
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 $645.65 Median $645.65 Typical High $676.08 | Professional | 52 · Reduced service | $645.65 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $933.25 |
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 $15,824MD $1,943
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.