How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,820 to $11,749Professionalmedian $692 · 10th to 90th $490 to $1,000
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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,698.24 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,380.38 | Professional | None | $630.96 | $707.95 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $954.99 | Professional | None | $724.44 | $954.99 | $954.99 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,912.51 Typical High $13,182.57 | Facility | None | $5,128.61 | $8,912.51 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,071.52 | Professional | None | $691.83 | $741.31 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,786.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $933.25 | Professional | None | $457.09 | $588.84 | $933.25 |
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 $338.84 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $478.63 |
Where New Jersey sits
The same service costs 7.6 times more in Oklahoma than in Texas. 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
OK $11,248TX $1,472
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.