How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,905 to $11,749Professionalmedian $1,318 · 10th to 90th $977 to $2,042
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 $4,466.84 Median $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
AmeriHealth Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,819.70 | Professional | None | $575.44 | $575.44 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,466.84 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,412.54 | $2,691.53 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,862.09 | $1,862.09 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,912.51 Typical High $27,542.29 | Facility | None | $5,011.87 | $8,912.51 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,479.11 | $2,089.30 |
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 $891.25 Median $1,122.02 Typical High $1,819.70 | Professional | None | $891.25 | $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 $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $933.25 |
Where New Jersey sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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
CO $14,661HI $3,664
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.