How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,514 to $12,589Professionalmedian $1,096 · 10th to 90th $794 to $1,698
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 $8,128.31 Typical High $14,125.38 | Facility | None | $1,096.48 | $8,128.31 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $5,011.87 Typical High $8,128.31 | Facility | None | $1,548.82 | $5,011.87 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,174.90 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,548.82 | $1,548.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $10,471.29 Typical High $27,542.29 | Facility | None | $5,888.44 | $10,471.29 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,230.27 | $1,737.80 |
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 $741.31 Median $954.99 Typical High $1,513.56 | Professional | None | $741.31 | $954.99 | $1,513.56 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $812.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $776.25 |
Where New Jersey sits
The same service costs 4.2 times more in Colorado than in Montana. 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 $14,362MT $3,396
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.