How much rates vary
Facilitymedian $4,169 · 10th to 90th $933 to $11,220Professionalmedian $501 · 10th to 90th $372 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 $501.19 Median $5,370.32 Typical High $10,471.29 | Facility | None | $501.19 | $5,370.32 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $812.83 | Professional | None | $489.78 | $512.86 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $4,265.80 Typical High $8,128.31 | Facility | None | $933.25 | $4,265.80 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $1,023.29 | Professional | None | $446.68 | $524.81 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $707.95 | Professional | None | $524.81 | $707.95 | $707.95 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $10,471.29 Typical High $27,542.29 | Facility | None | $5,754.40 | $10,471.29 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $812.83 | Professional | None | $489.78 | $537.03 | $812.83 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $707.95 | Professional | None | $338.84 | $426.58 | $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 $245.47 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $363.08 |
Where New Jersey sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.