How much rates vary
Facilitymedian $1,820 · 10th to 90th $380 to $8,511Professionalmedian $1,413 · 10th to 90th $1,096 to $3,311
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 $1,122.02 Median $1,122.02 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,122.02 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,023.29 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $3,715.35 | Professional | None | $1,202.26 | $1,412.54 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,949.84 | $1,949.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,548.82 | $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 $933.25 Median $1,318.26 Typical High $3,311.31 | Professional | None | $933.25 | $1,318.26 | $3,311.31 |
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 $562.34 Median $562.34 Typical High $851.14 | Professional | 52 · Reduced service | $562.34 | $562.34 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $338.84 | Professional | 53 · Discontinued | $223.87 | $223.87 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,288.25 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $257.04 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $169.82 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,202.26 |
Where New Jersey sits
The same service costs 12.0 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 $24,859MD $2,076
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.