How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,202 · 10th to 90th $891 to $2,399
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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,202.26 | $1,258.93 |
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 $741.31 Median $1,230.27 Typical High $2,818.38 | Professional | None | $741.31 | $1,230.27 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,698.24 | $1,737.80 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,258.93 | $3,019.95 |
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 $831.76 Median $1,174.90 Typical High $2,398.83 | Professional | None | $831.76 | $1,174.90 | $2,398.83 |
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 $549.54 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $912.01 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $181.97 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $851.14 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $851.14 | $870.96 |
Where New Jersey sits
The same service costs 15.4 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 $28,500MD $1,851
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.