How much rates vary
Facilitymedian $3,020 · 10th to 90th $589 to $8,128Professionalmedian $479 · 10th to 90th $324 to $776
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 $380.19 Median $4,570.88 Typical High $10,232.93 | Facility | None | $380.19 | $4,570.88 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $588.84 | Professional | None | $380.19 | $549.54 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,174.90 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $891.25 | Professional | None | $363.08 | $537.03 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $933.25 | Professional | None | $676.08 | $933.25 | $933.25 |
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 $380.19 Median $645.65 Typical High $1,047.13 | Professional | None | $380.19 | $645.65 | $1,047.13 |
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 $281.84 Median $436.52 Typical High $676.08 | Professional | None | $281.84 | $436.52 | $676.08 |
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 $190.55 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $190.55 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $117.49 | Professional | 53 · Discontinued | $75.86 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $363.08 Typical High $446.68 | Professional | 54 · Surgery only | $288.40 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $72.44 Typical High $89.13 | Professional | 55 · Aftercare only | $57.54 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.02 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $338.84 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $269.15 | $338.84 | $416.87 |
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 $6,438MT $1,383
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.