How much rates vary
Facilitymedian $1,820 · 10th to 90th $417 to $10,000Professionalmedian $1,380 · 10th to 90th $1,096 to $3,162
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 $1,096.48 Median $4,570.88 Typical High $11,748.98 | Facility | None | $1,096.48 | $4,570.88 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,318.26 | $2,454.71 |
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 $1,148.15 Median $1,380.38 Typical High $3,548.13 | Professional | None | $1,148.15 | $1,380.38 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,862.09 | $1,862.09 |
Horizon BCBS Setting Facility Modifier None Typical Low $17,378.01 Median $23,988.33 Typical High $30,199.52 | Facility | None | $17,378.01 | $23,988.33 | $30,199.52 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $3,467.37 | Professional | None | $1,288.25 | $1,513.56 | $3,467.37 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,754.40 | Facility | None | $331.13 | $1,479.11 | $5,754.40 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $3,235.94 | Professional | None | $891.25 | $1,258.93 | $3,235.94 |
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 $549.54 Median $549.54 Typical High $812.83 | Professional | 52 · Reduced service | $549.54 | $549.54 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $323.59 | Professional | 53 · Discontinued | $218.78 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,230.27 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $245.47 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $162.18 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $1,148.15 |
Where New Jersey sits
The same service costs 14.0 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 $28,122MD $2,008
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.