How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,318 to $11,749Professionalmedian $589 · 10th to 90th $457 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 $588.84 Median $6,606.93 Typical High $10,964.78 | Facility | None | $588.84 | $6,606.93 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $891.25 | Professional | None | $549.54 | $549.54 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
AmeriHealth Setting Facility Modifier None Typical Low $3,162.28 Median $8,317.64 Typical High $19,498.45 | Facility | None | $3,162.28 | $8,317.64 | $19,498.45 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $3,801.89 | Facility | None | $1,318.26 | $2,630.27 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,230.27 | Professional | None | $549.54 | $645.65 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $891.25 | Professional | None | $645.65 | $891.25 | $891.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,511.89 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $912.01 | Professional | None | $602.56 | $660.69 | $912.01 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,897.79 | $11,220.18 |
United Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $812.83 | Professional | None | $416.87 | $512.86 | $812.83 |
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 $275.42 Median $275.42 Typical High $295.12 | Professional | 52 · Reduced service | $275.42 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $109.65 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | 54 · Surgery only | $416.87 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $416.87 |
Where New Jersey sits
The same service costs 4.7 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 $8,820MT $1,888
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.