How much rates vary
Facilitymedian $1,905 · 10th to 90th $380 to $8,511Professionalmedian $1,995 · 10th to 90th $1,072 to $3,090
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 $1,905.46 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,905.46 | $1,905.46 | $1,995.26 |
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 $1,905.46 Median $3,090.30 Typical High $3,981.07 | Professional | None | $1,905.46 | $3,090.30 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,884.03 | $2,884.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,995.26 | $2,187.76 | $3,090.30 |
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 $977.24 Median $1,288.25 Typical High $2,951.21 | Professional | None | $977.24 | $1,288.25 | $2,951.21 |
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 $954.99 Median $954.99 Typical High $977.24 | Professional | 52 · Reduced service | $954.99 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | 53 · Discontinued | $380.19 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $295.12 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,380.38 |
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 $34,704TX $2,477
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.