How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $776 · 10th to 90th $562 to $1,230
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 $776.25 Median $776.25 Typical High $870.96 | Professional | None | $776.25 | $776.25 | $870.96 |
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 $588.84 Median $707.95 Typical High $1,380.38 | Professional | None | $588.84 | $707.95 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,348.96 | $1,479.11 |
Horizon BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,318.26 | Professional | None | $851.14 | $1,000.00 | $1,318.26 |
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 $524.81 Median $630.96 Typical High $933.25 | Professional | None | $524.81 | $630.96 | $933.25 |
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 $389.05 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $389.05 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $616.60 |
Where New Jersey sits
The same service costs 11.4 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 $16,997MD $1,496
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.