How much rates vary
Facilitymedian $3,388 · 10th to 90th $794 to $9,772Professionalmedian $871 · 10th to 90th $724 to $1,820
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 $741.31 Median $6,918.31 Typical High $12,022.64 | Facility | None | $741.31 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,513.56 | Professional | None | $741.31 | $776.25 | $1,513.56 |
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 $707.95 Median $831.76 Typical High $1,949.84 | Professional | None | $707.95 | $831.76 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | None | $794.33 | $1,148.15 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $2,137.96 | Professional | None | $758.58 | $891.25 | $2,137.96 |
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 $724.44 Median $954.99 Typical High $1,819.70 | Professional | None | $724.44 | $954.99 | $1,819.70 |
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 $371.54 Median $371.54 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $660.69 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 59 · Distinct service | $724.44 | $724.44 | $724.44 |
Where New Jersey sits
The same service costs 11.6 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 $23,484TX $2,029
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.