How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,318 to $12,882Professionalmedian $776 · 10th to 90th $575 to $1,259
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 $776.25 Median $6,760.83 Typical High $10,964.78 | Facility | None | $776.25 | $6,760.83 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,258.93 | Professional | None | $758.58 | $776.25 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
AmeriHealth Setting Facility Modifier None Typical Low $3,388.44 Median $8,317.64 Typical High $19,952.62 | Facility | None | $3,388.44 | $8,317.64 | $19,952.62 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,466.84 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,466.84 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,584.89 | Professional | None | $707.95 | $831.76 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
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 $794.33 Median $851.14 Typical High $1,318.26 | Professional | None | $794.33 | $851.14 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,047.13 | Professional | None | $537.03 | $660.69 | $1,047.13 |
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 $380.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $380.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $588.84 | Professional | 54 · Surgery only | $575.44 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $117.49 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $75.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $549.54 |
Where New Jersey sits
The same service costs 5.7 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 $13,613MT $2,377
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.