How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,479 to $12,589Professionalmedian $1,660 · 10th to 90th $1,175 to $2,570
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 $6,918.31 Typical High $11,748.98 | Facility | None | $4,466.84 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,584.89 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,995.26 | $8,912.51 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,737.80 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,479.11 | $2,290.87 | $2,290.87 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $3,715.35 Typical High $47,863.01 | Facility | None | $2,041.74 | $3,715.35 | $47,863.01 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,659.59 | $1,819.70 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,884.03 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,412.54 | $2,238.72 |
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 $831.76 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where New Jersey sits
The same service costs 6.3 times more in Alaska 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
AK $16,928TX $2,675
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.