How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,148 to $10,965Professionalmedian $1,738 · 10th to 90th $955 to $2,951
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 $1,096.48 Median $5,248.07 Typical High $11,748.98 | Facility | None | $1,096.48 | $5,248.07 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,398.83 | Professional | None | $1,023.29 | $2,137.96 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $4,570.88 Typical High $8,709.64 | Facility | None | $1,513.56 | $4,570.88 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,949.84 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,454.71 | $3,388.44 | $3,388.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $7,244.36 Typical High $22,387.21 | Facility | None | $3,801.89 | $7,244.36 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,096.48 | $2,344.23 | $3,981.07 |
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 $851.14 Median $1,584.89 Typical High $2,454.71 | Professional | None | $851.14 | $1,584.89 | $2,454.71 |
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 $512.86 Median $912.01 Typical High $1,202.26 | Professional | 52 · Reduced service | $512.86 | $912.01 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $363.08 Typical High $489.78 | Professional | 53 · Discontinued | $208.93 | $363.08 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,348.96 Typical High $1,819.70 | Professional | 54 · Surgery only | $776.25 | $1,348.96 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $275.42 Typical High $363.08 | Professional | 55 · Aftercare only | $154.88 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $181.97 Typical High $239.88 | Professional | 56 · Pre-op care only | $102.33 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,258.93 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $724.44 | $1,258.93 | $1,698.24 |
Where New Jersey sits
The same service costs 3.7 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 $13,607KY $3,727
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.