How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,820 to $15,488Professionalmedian $692 · 10th to 90th $427 to $1,047
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 $724.44 Typical High $724.44 | Professional | None | $691.83 | $724.44 | $724.44 |
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 $630.96 Median $831.76 Typical High $831.76 | Professional | None | $630.96 | $831.76 | $831.76 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $14,125.38 Typical High $22,908.68 | Facility | None | $7,943.28 | $14,125.38 | $22,908.68 |
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 $398.11 Median $512.86 Typical High $891.25 | Professional | None | $398.11 | $512.86 | $891.25 |
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 $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $524.81 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $512.86 |
Where New Jersey sits
The same service costs 6.1 times more in Alabama 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
AL $11,046MT $1,825
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.