How much rates vary
Facilitymedian $2,754 · 10th to 90th $708 to $9,333Professionalmedian $741 · 10th to 90th $479 to $1,413
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 $630.96 Median $5,370.32 Typical High $10,471.29 | Facility | None | $630.96 | $5,370.32 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,148.15 | Professional | None | $630.96 | $707.95 | $1,148.15 |
AmeriHealth Setting Facility Modifier None Typical Low $3,630.78 Median $8,912.51 Typical High $16,982.44 | Facility | None | $3,630.78 | $8,912.51 | $16,982.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,511.89 Typical High $4,265.80 | Facility | None | $933.25 | $2,511.89 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,445.44 | Professional | None | $537.03 | $776.25 | $1,445.44 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,174.90 | Professional | None | $851.14 | $1,148.15 | $1,174.90 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,019.95 Typical High $13,182.57 | Facility | None | $1,659.59 | $3,019.95 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,412.54 | Professional | None | $776.25 | $912.01 | $1,412.54 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,754.40 | Facility | None | $707.95 | $1,995.26 | $5,754.40 |
United Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $1,348.96 | Professional | None | $380.19 | $501.19 | $1,348.96 |
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 $309.03 Median $309.03 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $501.19 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Georgia. 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
AK $7,038GA $2,000
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.