How much rates vary
Facilitymedian $2,239 · 10th to 90th $933 to $6,918Professionalmedian $331 · 10th to 90th $263 to $513
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 $295.12 Median $295.12 Typical High $338.84 | Professional | None | $295.12 | $295.12 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,548.82 Typical High $2,238.72 | Facility | None | $724.44 | $1,548.82 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $691.83 | Professional | None | $309.03 | $363.08 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $501.19 | Professional | None | $371.54 | $501.19 | $501.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,511.89 Typical High $6,025.60 | Facility | None | $1,380.38 | $2,511.89 | $6,025.60 |
Horizon BCBS Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $524.81 | Professional | None | $338.84 | $371.54 | $524.81 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $457.09 | Professional | None | $239.88 | $288.40 | $457.09 |
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 $147.91 Median $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $147.91 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $60.26 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | 54 · Surgery only | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $223.87 |
Where New Jersey sits
The same service costs 4.6 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 $4,822MT $1,050
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.