How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $661 · 10th to 90th $490 to $1,072
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 $660.69 Median $660.69 Typical High $758.58 | Professional | None | $660.69 | $660.69 | $758.58 |
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 $512.86 Median $616.60 Typical High $1,202.26 | Professional | None | $512.86 | $616.60 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,288.25 | Professional | None | $870.96 | $1,174.90 | $1,288.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,148.15 | Professional | None | $741.31 | $870.96 | $1,148.15 |
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 $457.09 Median $549.54 Typical High $812.83 | Professional | None | $457.09 | $549.54 | $812.83 |
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 $331.13 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $537.03 |
Where New Jersey sits
The same service costs 12.3 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 $16,849MD $1,375
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.