How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,148 to $8,511Professionalmedian $1,202 · 10th to 90th $1,023 to $2,630
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 $1,148.15 Median $4,570.88 Typical High $11,748.98 | Facility | None | $1,148.15 | $4,570.88 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,148.15 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,071.52 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,202.26 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,584.89 | $1,584.89 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $3,090.30 | Professional | None | $1,122.02 | $1,318.26 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,318.26 | $2,630.27 |
7 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 $575.44 Typical High $676.08 | Professional | 52 · Reduced service | $549.54 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $218.78 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $933.25 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $177.83 | $177.83 |
Where New Jersey sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.