How much rates vary
Facilitymedian $2,884 · 10th to 90th $933 to $8,128Professionalmedian $380 · 10th to 90th $245 to $661
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 $645.65 Median $6,309.57 Typical High $10,471.29 | Facility | None | $645.65 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | None | $524.81 | $645.65 | $645.65 |
AmeriHealth Setting Facility Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $3,467.37 | Facility | None | $1,513.56 | $1,698.24 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $3,019.95 | Facility | None | $1,047.13 | $2,089.30 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $870.96 | Professional | None | $338.84 | $380.19 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $478.63 | Professional | None | $363.08 | $478.63 | $478.63 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $11,748.98 | Facility | None | $1,995.26 | $3,548.13 | $11,748.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $724.44 | Professional | None | $331.13 | $389.05 | $724.44 |
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 $223.87 Median $295.12 Typical High $602.56 | Professional | None | $223.87 | $295.12 | $602.56 |
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 $263.03 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $398.11 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $52.48 | $64.57 | $64.57 |
Where New Jersey sits
The same service costs 6.1 times more in Oklahoma 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
OK $6,602MT $1,074
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.