How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,288 to $10,471Professionalmedian $1,230 · 10th to 90th $871 to $1,995
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 $1,230.27 Median $6,918.31 Typical High $12,022.64 | Facility | None | $1,230.27 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,230.27 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $912.01 Median $1,122.02 Typical High $2,187.76 | Professional | None | $912.01 | $1,122.02 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,445.44 | $2,041.74 | $2,238.72 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,548.82 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,479.11 | Professional | None | $794.33 | $977.24 | $1,479.11 |
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 $616.60 Median $616.60 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $208.93 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $977.24 |
Where New Jersey sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.