How much rates vary
Facilitymedian $2,138 · 10th to 90th $794 to $6,761Professionalmedian $794 · 10th to 90th $617 to $1,259
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 $794.33 Median $5,495.41 Typical High $10,471.29 | Facility | None | $794.33 | $5,495.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,000.00 | Professional | None | $794.33 | $812.83 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,548.82 Typical High $2,238.72 | Facility | None | $724.44 | $1,548.82 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,621.81 | Professional | None | $758.58 | $851.14 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,202.26 | Professional | None | $891.25 | $1,202.26 | $1,202.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $6,456.54 | Facility | None | $1,318.26 | $2,511.89 | $6,456.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,258.93 | Professional | None | $794.33 | $870.96 | $1,258.93 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,096.48 | Professional | None | $575.44 | $691.83 | $1,096.48 |
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 $389.05 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $389.05 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $158.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $562.34 |
Where New Jersey sits
The same service costs 3.6 times more in Alaska than in Alabama. 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 $5,545AL $1,558
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.