How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,122 to $11,749Professionalmedian $776 · 10th to 90th $562 to $1,230
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 $6,309.57 Typical High $10,471.29 | Facility | None | $776.25 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $891.25 | Professional | None | $776.25 | $776.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,174.90 | $5,623.41 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,584.89 | Professional | None | $724.44 | $851.14 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,096.48 | Professional | None | $812.83 | $1,096.48 | $1,096.48 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,709.64 Typical High $27,542.29 | Facility | None | $4,786.30 | $8,709.64 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,230.27 | Professional | None | $794.33 | $870.96 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,071.52 | Professional | None | $512.86 | $660.69 | $1,071.52 |
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 $389.05 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $389.05 | $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 $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
Where New Jersey sits
The same service costs 6.0 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 $14,230MT $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.