How much rates vary
Facilitymedian $891 · 10th to 90th $95 to $5,370Professionalmedian $87 · 10th to 90th $38 to $182
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 $51.29 Median $120.23 Typical High $10,471.29 | Facility | None | $51.29 | $120.23 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $144.54 | Professional | None | $51.29 | $95.50 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
AmeriHealth Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
AmeriHealth Setting Professional Modifier None Typical Low $52.48 Median $141.25 Typical High $177.83 | Professional | None | $52.48 | $141.25 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $75.86 Typical High $165.96 | Professional | None | $35.48 | $75.86 | $165.96 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $229.09 | Professional | None | $162.18 | $218.78 | $229.09 |
Horizon BCBS Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $933.25 | Facility | None | $446.68 | $676.08 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $56.23 Median $128.82 Typical High $213.80 | Professional | None | $56.23 | $128.82 | $213.80 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $30.90 Median $74.13 Typical High $138.04 | Professional | None | $30.90 | $74.13 | $138.04 |
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 $25.70 Median $43.65 Typical High $60.26 | Professional | 52 · Reduced service | $25.70 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $17.38 Typical High $23.99 | Professional | 53 · Discontinued | $10.47 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $66.07 Typical High $89.13 | Professional | 54 · Surgery only | $38.90 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.18 Typical High $17.78 | Professional | 55 · Aftercare only | $7.76 | $13.18 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.71 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.13 | $8.71 | $12.02 |
Where New Jersey sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.