How much rates vary
Facilitymedian $550 · 10th to 90th $219 to $4,467Professionalmedian $309 · 10th to 90th $251 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 $263.03 Median $323.59 Typical High $10,471.29 | Facility | None | $263.03 | $323.59 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $346.74 | Professional | None | $263.03 | $302.00 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $371.54 | Facility | None | $141.25 | $245.47 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $616.60 | Professional | None | $281.84 | $338.84 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $616.60 | Professional | None | $457.09 | $616.60 | $616.60 |
Horizon BCBS Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $933.25 | Facility | None | $204.17 | $363.08 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $676.08 | Professional | None | $295.12 | $371.54 | $676.08 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $457.09 | Professional | None | $229.09 | $302.00 | $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 $131.83 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $131.83 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $52.48 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $199.53 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $186.21 | $204.17 | $229.09 |
Where New Jersey sits
The same service costs 6.7 times more in New York than in Florida. 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
NY $2,828FL $419
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.