How much rates vary
Facilitymedian $741 · 10th to 90th $224 to $6,457Professionalmedian $295 · 10th to 90th $234 to $479
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 $234.42 Median $288.40 Typical High $10,232.93 | Facility | None | $234.42 | $288.40 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $380.19 | Professional | None | $234.42 | $257.04 | $380.19 |
AmeriHealth Setting Facility Modifier None Typical Low $3,715.35 Median $6,456.54 Typical High $10,000.00 | Facility | None | $3,715.35 | $6,456.54 | $10,000.00 |
AmeriHealth Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $257.04 Median $295.12 Typical High $537.03 | Professional | None | $257.04 | $295.12 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $588.84 | Professional | None | $436.52 | $588.84 | $588.84 |
Horizon BCBS Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $1,000.00 | Facility | None | $199.53 | $363.08 | $1,000.00 |
Horizon BCBS Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $602.56 | Professional | None | $275.42 | $323.59 | $602.56 |
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 $234.42 Median $295.12 Typical High $416.87 | Professional | None | $234.42 | $295.12 | $416.87 |
7 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 $117.49 Median $128.82 Typical High $141.25 | Professional | 52 · Reduced service | $117.49 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $46.77 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $213.80 | Professional | 54 · Surgery only | $173.78 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.70 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.44 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $177.83 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $162.18 | $177.83 | $199.53 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $263.03 | $263.03 | $263.03 |
Where New Jersey sits
The same service costs 6.4 times more in Colorado 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
CO $2,602FL $408
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.