How much rates vary
Facilitymedian $2,089 · 10th to 90th $562 to $7,079Professionalmedian $501 · 10th to 90th $251 to $1,023
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 $371.54 Median $4,466.84 Typical High $9,772.37 | Facility | None | $371.54 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $794.33 | Professional | None | $346.74 | $562.34 | $794.33 |
AmeriHealth Setting Facility Modifier None Typical Low $2,344.23 Median $5,495.41 Typical High $9,332.54 | Facility | None | $2,344.23 | $5,495.41 | $9,332.54 |
AmeriHealth Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $251.19 Median $457.09 Typical High $1,071.52 | Professional | None | $251.19 | $457.09 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,122.02 | Professional | None | $794.33 | $1,071.52 | $1,122.02 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $11,748.98 | Facility | None | $1,995.26 | $3,548.13 | $11,748.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $398.11 Median $776.25 Typical High $1,412.54 | Professional | None | $398.11 | $776.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $4,168.69 | Facility | None | $537.03 | $1,548.82 | $4,168.69 |
United Setting Professional Modifier None Typical Low $194.98 Median $389.05 Typical High $870.96 | Professional | None | $194.98 | $389.05 | $870.96 |
5 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 $173.78 Median $263.03 Typical High $316.23 | Professional | 52 · Reduced service | $173.78 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $104.71 Typical High $125.89 | Professional | 53 · Discontinued | $69.18 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $389.05 Typical High $478.63 | Professional | 54 · Surgery only | $257.04 | $389.05 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $79.43 Typical High $95.50 | Professional | 55 · Aftercare only | $51.29 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $34.67 | $52.48 | $63.10 |
Where New Jersey sits
The same service costs 4.4 times more in Colorado than in Florida. 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 $5,606FL $1,277
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.