How much rates vary
Facilitymedian $1,698 · 10th to 90th $380 to $8,511Professionalmedian $646 · 10th to 90th $479 to $1,549
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 $691.83 Median $5,623.41 Typical High $11,748.98 | Facility | None | $691.83 | $5,623.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $758.58 | Professional | None | $645.65 | $645.65 | $758.58 |
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 $549.54 Median $660.69 Typical High $1,698.24 | Professional | None | $549.54 | $660.69 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $912.01 | Professional | None | $660.69 | $912.01 | $912.01 |
Horizon BCBS Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,778.28 | Professional | None | $616.60 | $724.44 | $1,778.28 |
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 $398.11 Median $562.34 Typical High $1,513.56 | Professional | None | $398.11 | $562.34 | $1,513.56 |
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 $323.59 Median $323.59 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $524.81 |
Where New Jersey sits
The same service costs 12.7 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 $16,379MD $1,287
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.