How much rates vary
Facilitymedian $1,698 · 10th to 90th $589 to $6,457Professionalmedian $1,318 · 10th to 90th $1,023 to $3,090
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 $1,047.13 Median $1,047.13 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,047.13 | $1,584.89 |
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 $1,096.48 Median $1,318.26 Typical High $3,388.44 | Professional | None | $1,096.48 | $1,318.26 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,819.70 | $1,819.70 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $3,388.44 | Professional | None | $1,230.27 | $1,445.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,548.82 Typical High $3,981.07 | Facility | None | $512.86 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $3,090.30 | Professional | None | $851.14 | $1,230.27 | $3,090.30 |
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 $512.86 Median $512.86 Typical High $776.25 | Professional | 52 · Reduced service | $512.86 | $512.86 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $316.23 | Professional | 53 · Discontinued | $208.93 | $208.93 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $776.25 | $776.25 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $234.42 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $158.49 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $1,096.48 |
Where New Jersey sits
The same service costs 13.1 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 $24,687MD $1,882
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.