How much rates vary
Facilitymedian $1,698 · 10th to 90th $380 to $8,511Professionalmedian $1,380 · 10th to 90th $1,000 to $2,291
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 $1,548.82 Median $5,623.41 Typical High $11,748.98 | Facility | None | $1,548.82 | $5,623.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,380.38 | $1,905.46 |
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 $1,071.52 Median $1,288.25 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,288.25 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,344.23 | $2,630.27 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,819.70 | $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 $912.01 Median $1,122.02 Typical High $1,659.59 | Professional | None | $912.01 | $1,122.02 | $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 $691.83 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,122.02 |
Where New Jersey sits
The same service costs 8.1 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 $2,222
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.