How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $871 · 10th to 90th $759 to $1,820
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 $831.76 Median $851.14 Typical High $1,584.89 | Professional | None | $831.76 | $851.14 | $1,584.89 |
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 $831.76 Median $933.25 Typical High $2,238.72 | Professional | None | $831.76 | $933.25 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,288.25 | Professional | None | $912.01 | $1,288.25 | $1,288.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $2,344.23 | Professional | None | $812.83 | $954.99 | $2,344.23 |
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 $602.56 Median $812.83 Typical High $1,819.70 | Professional | None | $602.56 | $812.83 | $1,819.70 |
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 $416.87 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $660.69 | Professional | 54 · Surgery only | $630.96 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $131.83 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $616.60 |
Where New Jersey sits
The same service costs 18.1 times more in Maine than in Arkansas. 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 $27,451AR $1,513
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.