How much rates vary
Facilitymedian $2,692 · 10th to 90th $427 to $7,586Professionalmedian $309 · 10th to 90th $178 to $617
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 $257.04 Median $4,466.84 Typical High $9,772.37 | Facility | None | $257.04 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $501.19 | Professional | None | $223.87 | $309.03 | $501.19 |
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 $177.83 Median $316.23 Typical High $616.60 | Professional | None | $177.83 | $316.23 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $676.08 | Professional | None | $478.63 | $645.65 | $676.08 |
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 $281.84 Median $467.74 Typical High $691.83 | Professional | None | $281.84 | $467.74 | $691.83 |
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 $134.90 Median $239.88 Typical High $549.54 | Professional | None | $134.90 | $239.88 | $549.54 |
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 $112.20 Median $154.88 Typical High $177.83 | Professional | 52 · Reduced service | $112.20 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $44.67 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $229.09 Typical High $269.15 | Professional | 54 · Surgery only | $169.82 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $45.71 Typical High $53.70 | Professional | 55 · Aftercare only | $33.88 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.39 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $213.80 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $213.80 | $251.19 |
Where New Jersey sits
The same service costs 6.1 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 $6,346MT $1,043
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.