How much rates vary
Facilitymedian $8,128 · 10th to 90th $1,622 to $31,623Professionalmedian $1,585 · 10th to 90th $1,175 to $2,630
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 $1,548.82 Median $8,511.38 Typical High $17,378.01 | Facility | None | $1,548.82 | $8,511.38 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,548.82 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
AmeriHealth Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $4,265.80 | Professional | None | $1,380.38 | $1,548.82 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $26,915.35 Typical High $42,657.95 | Facility | None | $1,995.26 | $26,915.35 | $42,657.95 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,659.59 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,479.11 | $2,238.72 | $2,238.72 |
Horizon BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $10,471.29 Typical High $87,096.36 | Facility | None | $6,760.83 | $10,471.29 | $87,096.36 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,737.80 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,754.40 Typical High $15,488.17 | Facility | None | $1,659.59 | $5,754.40 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,348.96 | $2,187.76 |
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 $758.58 Median $758.58 Typical High $794.33 | Professional | 52 · Reduced service | $758.58 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,122.02 |
Where New Jersey sits
The same service costs 10.6 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 $37,069KY $3,499
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.