How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $1,096 · 10th to 90th $955 to $2,951
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 $1,000.00 Median $1,023.29 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,023.29 | $1,288.25 |
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 $954.99 Median $1,584.89 Typical High $3,548.13 | Professional | None | $954.99 | $1,584.89 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,548.82 | $1,621.81 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $3,311.31 | Professional | None | $1,023.29 | $1,096.48 | $3,311.31 |
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 $870.96 Median $1,174.90 Typical High $4,786.30 | Professional | None | $870.96 | $1,174.90 | $4,786.30 |
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 $501.19 Median $512.86 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $204.17 Typical High $218.78 | Professional | 53 · Discontinued | $199.53 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $102.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $776.25 |
Where New Jersey sits
The same service costs 9.8 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 $16,204MD $1,659
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.