How much rates vary
Facilitymedian $2,692 · 10th to 90th $550 to $7,586Professionalmedian $479 · 10th to 90th $347 to $813
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 $398.11 Median $4,570.88 Typical High $10,000.00 | Facility | None | $398.11 | $4,570.88 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $691.83 | Professional | None | $398.11 | $524.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,949.84 Typical High $2,884.03 | Facility | None | $933.25 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $891.25 | Professional | None | $398.11 | $524.81 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $891.25 | Professional | None | $645.65 | $891.25 | $891.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $10,964.78 | Facility | None | $1,905.46 | $3,548.13 | $10,964.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $1,071.52 | Professional | None | $416.87 | $616.60 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $691.83 | Professional | None | $295.12 | $426.58 | $691.83 |
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 $194.98 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $194.98 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $79.43 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $295.12 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $58.88 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $39.81 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $323.59 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $275.42 | $323.59 | $380.19 |
Where New Jersey sits
The same service costs 4.7 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 $6,464MT $1,390
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.