How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,023 · 10th to 90th $871 to $2,692
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 $891.25 Median $891.25 Typical High $1,148.15 | Professional | None | $891.25 | $891.25 | $1,148.15 |
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 $870.96 Median $1,479.11 Typical High $3,162.28 | Professional | None | $870.96 | $1,479.11 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,479.11 | $1,513.56 |
Horizon BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $2,951.21 | Professional | None | $933.25 | $1,023.29 | $2,951.21 |
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 $794.33 Median $1,071.52 Typical High $4,365.16 | Professional | None | $794.33 | $1,071.52 | $4,365.16 |
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 $446.68 Median $446.68 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $707.95 |
Where New Jersey sits
The same service costs 10.1 times more in Maine than in Arkansas. 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 $16,050AR $1,584
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.