How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,202 to $7,943Professionalmedian $447 · 10th to 90th $316 to $832
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 $2,754.23 Median $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $660.69 | Professional | None | $363.08 | $537.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $3,630.78 | Facility | None | $933.25 | $2,238.72 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $912.01 | Professional | None | $363.08 | $537.03 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $870.96 | Professional | None | $549.54 | $870.96 | $870.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,949.84 | $3,548.13 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $1,174.90 | Professional | None | $426.58 | $724.44 | $1,174.90 |
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 $263.03 Median $416.87 Typical High $707.95 | Professional | None | $263.03 | $416.87 | $707.95 |
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 $181.97 Median $251.19 Typical High $331.13 | Professional | 52 · Reduced service | $181.97 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $72.44 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $371.54 Typical High $501.19 | Professional | 54 · Surgery only | $269.15 | $371.54 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $74.13 Typical High $100.00 | Professional | 55 · Aftercare only | $53.70 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $50.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $36.31 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $346.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $251.19 | $346.74 | $467.74 |
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 $6,451MT $1,460
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.