How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,995 to $11,220Professionalmedian $955 · 10th to 90th $724 to $1,479
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 $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 $912.01 Median $912.01 Typical High $954.99 | Professional | None | $912.01 | $912.01 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,818.38 Typical High $4,677.35 | Facility | None | $1,862.09 | $2,818.38 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,949.84 | Professional | None | $870.96 | $1,023.29 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,412.54 | $1,412.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,709.64 Typical High $13,182.57 | Facility | None | $5,128.61 | $8,709.64 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,584.89 | Professional | None | $977.24 | $1,047.13 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,786.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,288.25 | Professional | None | $660.69 | $831.76 | $1,288.25 |
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 $457.09 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $660.69 |
Where New Jersey sits
The same service costs 5.0 times more in Oklahoma than in Texas. 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 $11,096TX $2,225
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.