How much rates vary
Facilitymedian $3,388 · 10th to 90th $871 to $9,772Professionalmedian $501 · 10th to 90th $417 to $1,096
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 $457.09 Median $6,918.31 Typical High $12,022.64 | Facility | None | $457.09 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $446.68 Typical High $549.54 | Professional | None | $436.52 | $446.68 | $549.54 |
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 $416.87 Median $512.86 Typical High $1,148.15 | Professional | None | $416.87 | $512.86 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | None | $478.63 | $660.69 | $660.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $1,230.27 | Professional | None | $436.52 | $512.86 | $1,230.27 |
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 $416.87 Median $549.54 Typical High $1,047.13 | Professional | None | $416.87 | $549.54 | $1,047.13 |
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 $218.78 Median $218.78 Typical High $269.15 | Professional | 52 · Reduced service | $218.78 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $89.13 Typical High $109.65 | Professional | 53 · Discontinued | $87.10 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $43.65 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $380.19 |
Where New Jersey sits
The same service costs 17.8 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 $23,004TX $1,295
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.