How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,349 to $14,791Professionalmedian $1,445 · 10th to 90th $776 to $3,388
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 $1,202.26 Median $6,760.83 Typical High $12,022.64 | Facility | None | $1,202.26 | $6,760.83 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,230.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $5,495.41 Typical High $10,000.00 | Facility | None | $1,513.56 | $5,495.41 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,412.54 Typical High $3,801.89 | Professional | None | $776.25 | $1,412.54 | $3,801.89 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,737.80 | $1,737.80 |
Horizon BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $12,302.69 Typical High $51,286.14 | Facility | None | $6,456.54 | $12,302.69 | $51,286.14 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $3,890.45 | Professional | None | $1,479.11 | $1,737.80 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $3,311.31 | Professional | None | $645.65 | $1,096.48 | $3,311.31 |
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 $588.84 Median $602.56 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $954.99 |
Where New Jersey sits
The same service costs 6.3 times more in Wyoming than in Hawaii. 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
WY $21,505HI $3,422
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.