How much rates vary
Facilitymedian $3,090 · 10th to 90th $933 to $7,762Professionalmedian $295 · 10th to 90th $209 to $479
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 $295.12 Median $4,570.88 Typical High $10,471.29 | Facility | None | $295.12 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $467.74 | Professional | None | $288.40 | $309.03 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $3,630.78 | Facility | None | $691.83 | $2,137.96 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $588.84 | Professional | None | $263.03 | $302.00 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $407.38 | Professional | None | $302.00 | $407.38 | $407.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,511.89 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $478.63 | Professional | None | $288.40 | $316.23 | $478.63 |
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 $190.55 Median $251.19 Typical High $446.68 | Professional | None | $190.55 | $251.19 | $446.68 |
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 $144.54 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $57.54 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $43.65 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $204.17 | $213.80 | $213.80 |
Where New Jersey sits
The same service costs 7.3 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 $6,269MT $863
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.