How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,995 to $12,303Professionalmedian $1,738 · 10th to 90th $1,230 to $2,512
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 $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,309.57 Typical High $11,220.18 | Facility | None | $1,995.26 | $6,309.57 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,584.89 | $1,819.70 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,778.28 | $2,344.23 | $2,344.23 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $9,772.37 Typical High $29,512.09 | Facility | None | $5,370.32 | $9,772.37 | $29,512.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,737.80 | $1,862.09 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,445.44 | $2,344.23 |
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 $851.14 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $169.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Where New Jersey sits
The same service costs 4.7 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 $16,761KY $3,604
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.