How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,514 · 10th to 90th $1,096 to $2,570
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 $1,513.56 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,513.56 | $2,089.30 |
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 $1,174.90 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,412.54 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,570.40 | $2,884.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,698.24 | $1,995.26 | $2,630.27 |
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 $1,000.00 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,230.27 | $1,862.09 |
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 $758.58 Median $758.58 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 53 · Discontinued | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,230.27 |
Where New Jersey sits
The same service costs 7.6 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 $18,140MD $2,382
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.