How much rates vary
Facilitymedian $2,754 · 10th to 90th $427 to $7,586Professionalmedian $200 · 10th to 90th $123 to $389
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 $158.49 Median $4,466.84 Typical High $9,772.37 | Facility | None | $158.49 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $302.00 | Professional | None | $138.04 | $181.97 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,949.84 Typical High $2,884.03 | Facility | None | $933.25 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $380.19 | Professional | None | $144.54 | $223.87 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $467.74 | Professional | None | $338.84 | $446.68 | $467.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,548.13 | $10,964.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $407.38 | Professional | None | $173.78 | $295.12 | $407.38 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $346.74 | Professional | None | $95.50 | $154.88 | $346.74 |
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 $69.18 Median $91.20 Typical High $109.65 | Professional | 52 · Reduced service | $69.18 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $27.54 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $102.33 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $20.42 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.20 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.80 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $95.50 | $125.89 | $154.88 |
Where New Jersey sits
The same service costs 9.3 times more in Colorado than in Montana. 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
CO $5,912MT $637
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.