How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,023 to $10,965Professionalmedian $724 · 10th to 90th $513 to $1,148
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 $691.83 Median $6,309.57 Typical High $10,471.29 | Facility | None | $691.83 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | None | $691.83 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $5,495.41 Typical High $10,471.29 | Facility | None | $1,174.90 | $5,495.41 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,479.11 | Professional | None | $660.69 | $758.58 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,000.00 | Professional | None | $645.65 | $1,000.00 | $1,000.00 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $8,128.31 Typical High $29,512.09 | Facility | None | $4,365.16 | $8,128.31 | $29,512.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,202.26 | Professional | None | $707.95 | $776.25 | $1,202.26 |
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 $478.63 Median $616.60 Typical High $1,000.00 | Professional | None | $478.63 | $616.60 | $1,000.00 |
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 $346.74 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $346.74 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $138.04 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $537.03 |
Where New Jersey sits
The same service costs 6.4 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 $13,837MT $2,168
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.