How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,413 to $10,715Professionalmedian $1,349 · 10th to 90th $933 to $1,905
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 $4,365.16 Median $6,760.83 Typical High $11,481.54 | Facility | None | $4,365.16 | $6,760.83 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,318.26 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,995.26 | $6,165.95 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,412.54 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,819.70 | $1,819.70 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $3,715.35 Typical High $27,542.29 | Facility | None | $2,041.74 | $3,715.35 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,445.44 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $7,079.46 | Facility | None | $1,122.02 | $2,818.38 | $7,079.46 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,819.70 | Professional | None | $870.96 | $1,122.02 | $1,819.70 |
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 $660.69 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,000.00 |
Where New Jersey sits
The same service costs 6.1 times more in Alaska than in Texas. 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 $14,041TX $2,290
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.