How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,072 to $11,749Professionalmedian $891 · 10th to 90th $676 to $1,479
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 $870.96 Median $6,309.57 Typical High $10,471.29 | Facility | None | $870.96 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,445.44 | Professional | None | $870.96 | $870.96 | $1,445.44 |
AmeriHealth Setting Facility Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $5,248.07 | Facility | None | $2,089.30 | $2,754.23 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,174.90 | $5,495.41 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,862.09 | Professional | None | $831.76 | $1,000.00 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | None | $977.24 | $1,318.26 | $1,318.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,912.51 Typical High $29,512.09 | Facility | None | $4,786.30 | $8,912.51 | $29,512.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,479.11 | Professional | None | $912.01 | $1,000.00 | $1,479.11 |
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 $630.96 Median $776.25 Typical High $1,230.27 | Professional | None | $630.96 | $776.25 | $1,230.27 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $645.65 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $616.60 |
Where New Jersey sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.