How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,000 to $11,220Professionalmedian $1,047 · 10th to 90th $891 to $2,291
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 $933.25 Median $6,918.31 Typical High $13,803.84 | Facility | None | $933.25 | $6,918.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,862.09 | Professional | None | $933.25 | $954.99 | $1,862.09 |
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 $851.14 Median $1,000.00 Typical High $2,344.23 | Professional | None | $851.14 | $1,000.00 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $1,380.38 | Professional | None | $954.99 | $1,380.38 | $1,380.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $17,378.01 Median $23,988.33 Typical High $30,199.52 | Facility | None | $17,378.01 | $23,988.33 | $30,199.52 |
Horizon BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $2,570.40 | Professional | None | $933.25 | $1,096.48 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $2,187.76 | Professional | None | $851.14 | $1,122.02 | $2,187.76 |
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 $457.09 Median $467.74 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $776.25 |
Where New Jersey sits
The same service costs 9.9 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 $23,705TX $2,398
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.