How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,148 to $10,965Professionalmedian $490 · 10th to 90th $380 to $813
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 $467.74 Median $6,918.31 Typical High $13,803.84 | Facility | None | $467.74 | $6,918.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $831.76 | Professional | None | $467.74 | $467.74 | $831.76 |
AmeriHealth Setting Facility Modifier None Typical Low $2,137.96 Median $8,128.31 Typical High $17,378.01 | Facility | None | $2,137.96 | $8,128.31 | $17,378.01 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $2,951.21 Typical High $4,570.88 | Facility | None | $1,513.56 | $2,951.21 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $1,023.29 | Professional | None | $457.09 | $537.03 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $741.31 | Professional | None | $549.54 | $741.31 | $741.31 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $12,302.69 | Facility | None | $2,511.89 | $4,365.16 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $831.76 | Professional | None | $501.19 | $549.54 | $831.76 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $676.08 | Professional | None | $346.74 | $436.52 | $676.08 |
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 $234.42 Median $234.42 Typical High $239.88 | Professional | 52 · Reduced service | $234.42 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 54 · Surgery only | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $47.86 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $338.84 |
Where New Jersey sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.