How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $955 · 10th to 90th $708 to $1,549
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 $954.99 Median $954.99 Typical High $1,174.90 | Professional | None | $954.99 | $954.99 | $1,174.90 |
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 $741.31 Median $891.25 Typical High $1,737.80 | Professional | None | $741.31 | $891.25 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,659.59 | $1,862.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,258.93 | $1,659.59 |
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 $645.65 Median $776.25 Typical High $1,174.90 | Professional | None | $645.65 | $776.25 | $1,174.90 |
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 $478.63 Median $478.63 Typical High $549.54 | Professional | 52 · Reduced service | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $218.78 | Professional | 53 · Discontinued | $194.98 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $724.44 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $776.25 |
Where New Jersey sits
The same service costs 10.0 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 $17,294MD $1,737
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.