How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,202 to $11,749Professionalmedian $776 · 10th to 90th $589 to $1,202
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 $776.25 Median $6,918.31 Typical High $13,803.84 | Facility | None | $776.25 | $6,918.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | None | $776.25 | $776.25 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $4,365.16 Typical High $6,760.83 | Facility | None | $2,137.96 | $4,365.16 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Professional | None | $758.58 | $891.25 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,511.38 Typical High $23,988.33 | Facility | None | $4,466.84 | $8,511.38 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,348.96 | Professional | None | $776.25 | $912.01 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,122.02 | Professional | None | $537.03 | $691.83 | $1,122.02 |
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 $389.05 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $588.84 |
Where New Jersey sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $10,315KY $2,095
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.