How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,479 · 10th to 90th $1,175 to $3,548
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 $1,174.90 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,174.90 | $1,819.70 |
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 $1,258.93 Median $1,513.56 Typical High $3,890.45 | Professional | None | $1,258.93 | $1,513.56 | $3,890.45 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,380.38 | $2,041.74 | $2,041.74 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $3,890.45 | Professional | None | $1,412.54 | $1,659.59 | $3,890.45 |
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 $954.99 Median $1,380.38 Typical High $3,548.13 | Professional | None | $954.99 | $1,380.38 | $3,548.13 |
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 $588.84 Median $588.84 Typical High $891.25 | Professional | 52 · Reduced service | $588.84 | $588.84 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $363.08 | Professional | 53 · Discontinued | $234.42 | $234.42 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,348.96 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $269.15 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $181.97 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,258.93 |
Where New Jersey sits
The same service costs 11.6 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 $24,998MD $2,147
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.