How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,549 to $8,511Professionalmedian $1,288 · 10th to 90th $617 to $1,862
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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,318.26 | Professional | None | $616.60 | $616.60 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $3,801.89 | Facility | None | $933.25 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,380.38 | $2,344.23 |
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 $2,630.27 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,630.27 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,445.44 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,621.81 | Professional | None | $831.76 | $1,071.52 | $1,621.81 |
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 $309.03 Median $309.03 Typical High $645.65 | Professional | 52 · Reduced service | $309.03 | $309.03 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $257.04 | Professional | 53 · Discontinued | $123.03 | $123.03 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $977.24 | Professional | 54 · Surgery only | $457.09 | $457.09 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $194.98 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $128.82 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $912.01 |
Where New Jersey sits
The same service costs 3.7 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 $9,494KY $2,537
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.