How much rates vary
Facilitymedian $1,778 · 10th to 90th $437 to $6,166Professionalmedian $427 · 10th to 90th $355 to $708
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 $407.38 Median $4,786.30 Typical High $10,232.93 | Facility | None | $407.38 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $436.52 | Professional | None | $389.05 | $416.87 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,584.89 Typical High $2,344.23 | Facility | None | $724.44 | $1,584.89 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $851.14 | Professional | None | $398.11 | $457.09 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $812.83 | Professional | None | $602.56 | $812.83 | $812.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $6,456.54 | Facility | None | $1,318.26 | $2,454.71 | $6,456.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $912.01 | Professional | None | $426.58 | $501.19 | $912.01 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,584.89 Typical High $3,981.07 | Facility | None | $537.03 | $1,584.89 | $3,981.07 |
United Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $616.60 | Professional | None | $323.59 | $416.87 | $616.60 |
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 $194.98 Median $208.93 Typical High $218.78 | Professional | 52 · Reduced service | $194.98 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $77.62 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $295.12 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $309.03 |
Where New Jersey sits
The same service costs 4.5 times more in Vermont than in Florida. 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
VT $4,521FL $1,007
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.