How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,549 to $9,120Professionalmedian $603 · 10th to 90th $447 to $933
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 $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | None | $575.44 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,174.90 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,230.27 | Professional | None | $549.54 | $630.96 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | None | $645.65 | $870.96 | $870.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $13,182.57 | Facility | None | $2,630.27 | $4,677.35 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,047.13 | Professional | None | $588.84 | $645.65 | $1,047.13 |
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 $407.38 Median $524.81 Typical High $851.14 | Professional | None | $407.38 | $524.81 | $851.14 |
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 $281.84 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $436.52 |
Where New Jersey sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.