How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $13,804Professionalmedian $741 · 10th to 90th $550 to $1,230
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 $741.31 Median $6,309.57 Typical High $11,748.98 | Facility | None | $741.31 | $6,309.57 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,202.26 | Professional | None | $707.95 | $741.31 | $1,202.26 |
AmeriHealth Setting Facility Modifier None Typical Low $3,162.28 Median $8,317.64 Typical High $19,952.62 | Facility | None | $3,162.28 | $8,317.64 | $19,952.62 |
AmeriHealth Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,995.26 | Professional | None | $645.65 | $724.44 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $5,754.40 Typical High $10,715.19 | Facility | None | $1,174.90 | $5,754.40 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,513.56 | Professional | None | $676.08 | $794.33 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | None | $794.33 | $1,071.52 | $1,071.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $27,542.29 | Facility | None | $4,677.35 | $8,511.38 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,174.90 | Professional | None | $758.58 | $812.83 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,000.00 | Professional | None | $501.19 | $630.96 | $1,000.00 |
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 $363.08 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $363.08 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Where New Jersey sits
The same service costs 6.1 times more in Colorado 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
CO $13,882MT $2,270
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.