How much rates vary
Facilitymedian $1,905 · 10th to 90th $380 to $8,511Professionalmedian $2,344 · 10th to 90th $1,995 to $6,310
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 $2,041.74 Median $2,041.74 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,041.74 | $2,691.53 |
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 $2,089.30 Median $3,388.44 Typical High $7,244.36 | Professional | None | $2,089.30 | $3,388.44 | $7,244.36 |
Emblem Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $3,388.44 | Professional | None | $2,398.83 | $3,235.94 | $3,388.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $6,918.31 | Professional | None | $2,187.76 | $2,344.23 | $6,918.31 |
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 $1,862.09 Median $2,454.71 Typical High $10,471.29 | Professional | None | $1,862.09 | $2,454.71 | $10,471.29 |
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 $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | 53 · Discontinued | $407.38 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,659.59 |
Where New Jersey sits
The same service costs 14.0 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 $35,243TX $2,509
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.