How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,288 to $11,749Professionalmedian $661 · 10th to 90th $501 to $1,072
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 $660.69 Median $6,918.31 Typical High $11,748.98 | Facility | None | $660.69 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $741.31 | Professional | None | $630.96 | $660.69 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $6,309.57 Typical High $12,022.64 | Facility | None | $1,318.26 | $6,309.57 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,380.38 | Professional | None | $616.60 | $724.44 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $977.24 | Professional | None | $724.44 | $977.24 | $977.24 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $6,918.31 Typical High $29,512.09 | Facility | None | $3,801.89 | $6,918.31 | $29,512.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,096.48 | Professional | None | $676.08 | $741.31 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $912.01 | Professional | None | $467.74 | $575.44 | $912.01 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
Where New Jersey sits
The same service costs 5.4 times more in Alaska than in Montana. 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 $11,142MT $2,070
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.