How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,349 · 10th to 90th $977 to $2,188
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 $1,348.96 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,348.96 | $1,621.81 |
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 $1,047.13 Median $1,258.93 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,258.93 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $2,570.40 | Professional | None | $1,737.80 | $2,290.87 | $2,570.40 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,778.28 | $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 $891.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $891.25 | $1,071.52 | $1,659.59 |
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 $676.08 Median $676.08 Typical High $776.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $275.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,096.48 |
Where New Jersey sits
The same service costs 8.2 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 $17,891MD $2,184
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.