How much rates vary
Facilitymedian $1,862 · 10th to 90th $347 to $8,511Professionalmedian $263 · 10th to 90th $209 to $562
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 $257.04 Median $257.04 Typical High $489.78 | Professional | None | $257.04 | $257.04 | $489.78 |
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 $173.78 Median $288.40 Typical High $676.08 | Professional | None | $173.78 | $288.40 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $389.05 | Professional | None | $269.15 | $371.54 | $389.05 |
Horizon BCBS Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $724.44 | Professional | None | $251.19 | $302.00 | $724.44 |
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 $186.21 Median $263.03 Typical High $562.34 | Professional | None | $186.21 | $263.03 | $562.34 |
5 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 $128.82 Median $128.82 Typical High $141.25 | Professional | 52 · Reduced service | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $56.23 | Professional | 53 · Discontinued | $51.29 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | 54 · Surgery only | $190.55 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $28.18 |
Where New Jersey sits
The same service costs 32.0 times more in Maine than in Montana. 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 $26,674MT $834
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.