How much rates vary
Facilitymedian $2,754 · 10th to 90th $603 to $7,586Professionalmedian $513 · 10th to 90th $363 to $851
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 $416.87 Median $4,570.88 Typical High $10,000.00 | Facility | None | $416.87 | $4,570.88 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $616.60 | Professional | None | $416.87 | $562.34 | $616.60 |
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 $416.87 Median $575.44 Typical High $954.99 | Professional | None | $416.87 | $575.44 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $724.44 | $1,000.00 | $1,000.00 |
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 $436.52 Median $676.08 Typical High $1,122.02 | Professional | None | $436.52 | $676.08 | $1,122.02 |
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 $316.23 Median $467.74 Typical High $741.31 | Professional | None | $316.23 | $467.74 | $741.31 |
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 $208.93 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $100.00 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $380.19 Typical High $457.09 | Professional | 54 · Surgery only | $316.23 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $63.10 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $354.81 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $295.12 | $354.81 | $426.58 |
Where New Jersey sits
The same service costs 4.4 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 $6,491MT $1,489
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.