How much rates vary
Facilitymedian $6,310 · 10th to 90th $2,042 to $12,882Professionalmedian $2,188 · 10th to 90th $1,514 to $3,090
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 $4,466.84 Median $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,137.96 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,025.60 Typical High $10,715.19 | Facility | None | $1,995.26 | $6,025.60 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $4,466.84 | Professional | None | $2,041.74 | $2,290.87 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,951.21 | $2,951.21 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $9,772.37 Typical High $29,512.09 | Facility | None | $5,128.61 | $9,772.37 | $29,512.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $3,388.44 | Professional | None | $2,187.76 | $2,398.83 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,786.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,819.70 | $3,019.95 |
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 $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,071.52 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,621.81 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $323.59 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $213.80 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,659.59 | $1,659.59 |
Where New Jersey sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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
AK $18,744KY $4,349
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.