How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,738 · 10th to 90th $1,230 to $2,754
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 $1,737.80 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,737.80 | $1,995.26 |
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 $1,318.26 Median $1,621.81 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,621.81 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $3,311.31 | Professional | None | $2,187.76 | $2,951.21 | $3,311.31 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,905.46 | $2,238.72 | $3,019.95 |
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 $1,148.15 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,380.38 | $2,137.96 |
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 $870.96 Median $870.96 Typical High $1,000.00 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | 53 · Discontinued | $346.74 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,380.38 |
Where New Jersey sits
The same service costs 6.9 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 $18,419MD $2,652
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.