How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,096 to $11,749Professionalmedian $692 · 10th to 90th $525 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 $676.08 Median $6,309.57 Typical High $10,964.78 | Facility | None | $676.08 | $6,309.57 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,148.15 | Professional | None | $676.08 | $676.08 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $5,370.32 Typical High $10,232.93 | Facility | None | $1,174.90 | $5,370.32 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,412.54 | Professional | None | $645.65 | $758.58 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,023.29 | Professional | None | $645.65 | $1,023.29 | $1,023.29 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,912.51 Typical High $27,542.29 | Facility | None | $4,786.30 | $8,912.51 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,148.15 | Professional | None | $707.95 | $776.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $954.99 | Professional | None | $478.63 | $602.56 | $954.99 |
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 $338.84 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $478.63 |
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 $13,816MT $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.