How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,349 to $11,749Professionalmedian $1,479 · 10th to 90th $1,230 to $3,981
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 $1,348.96 Median $8,511.38 Typical High $13,803.84 | Facility | None | $1,348.96 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,348.96 | $2,818.38 |
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 $1,258.93 Median $2,137.96 Typical High $4,677.35 | Professional | None | $1,258.93 | $2,137.96 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,905.46 | $1,949.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $4,365.16 | Professional | None | $1,380.38 | $1,479.11 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,786.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $6,309.57 | Professional | None | $1,122.02 | $1,445.44 | $6,309.57 |
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 $660.69 Median $676.08 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | 53 · Discontinued | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $218.78 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,023.29 |
Where New Jersey sits
The same service costs 13.5 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 $34,179TX $2,531
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.