How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,230 to $25,119Professionalmedian $1,175 · 10th to 90th $832 to $1,660
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 $1,148.15 Median $7,244.36 Typical High $12,882.50 | Facility | None | $1,148.15 | $7,244.36 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,148.15 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $19,054.61 Typical High $32,359.37 | Facility | None | $1,995.26 | $19,054.61 | $32,359.37 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,230.27 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,621.81 | $1,621.81 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $9,549.93 Typical High $66,069.34 | Facility | None | $5,011.87 | $9,549.93 | $66,069.34 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,258.93 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $12,302.69 | Facility | None | $1,621.81 | $4,786.30 | $12,302.69 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,584.89 | Professional | None | $758.58 | $1,000.00 | $1,584.89 |
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 $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $229.09 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $831.76 |
Where New Jersey sits
The same service costs 9.3 times more in Alaska than in Kentucky. 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
AK $26,344KY $2,834
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.