How much rates vary
Facilitymedian $1,698 · 10th to 90th $263 to $8,511Professionalmedian $186 · 10th to 90th $34 to $692
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 $37.15 Median $3,467.37 Typical High $10,000.00 | Facility | None | $37.15 | $3,467.37 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $269.15 Typical High $549.54 | Professional | None | $35.48 | $269.15 | $549.54 |
AmeriHealth Setting Facility Modifier None Typical Low $1,995.26 Median $8,317.64 Typical High $13,489.63 | Facility | None | $1,995.26 | $8,317.64 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,023.29 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $223.87 Typical High $794.33 | Professional | None | $33.88 | $223.87 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $478.63 | Professional | None | $309.03 | $478.63 | $478.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $41.69 Median $426.58 Typical High $812.83 | Professional | None | $41.69 | $426.58 | $812.83 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,412.54 Typical High $3,890.45 | Facility | None | $309.03 | $1,412.54 | $3,890.45 |
United Setting Professional Modifier None Typical Low $23.44 Median $147.91 Typical High $691.83 | Professional | None | $23.44 | $147.91 | $691.83 |
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 $17.38 Median $70.79 Typical High $177.83 | Professional | 52 · Reduced service | $17.38 | $70.79 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $28.18 Typical High $72.44 | Professional | 53 · Discontinued | $7.08 | $28.18 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $104.71 Typical High $269.15 | Professional | 54 · Surgery only | $26.30 | $104.71 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $21.38 Typical High $53.70 | Professional | 55 · Aftercare only | $5.25 | $21.38 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $14.13 Typical High $35.48 | Professional | 56 · Pre-op care only | $3.55 | $14.13 | $35.48 |
Where New Jersey sits
The same service costs 10.7 times more in Utah 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
UT $3,011MT $281
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.