How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,202 to $8,128Professionalmedian $417 · 10th to 90th $295 to $692
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 $2,754.23 Median $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $512.86 | Professional | None | $338.84 | $446.68 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $3,630.78 | Facility | None | $933.25 | $2,238.72 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $812.83 | Professional | None | $331.13 | $478.63 | $812.83 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $812.83 | Professional | None | $512.86 | $812.83 | $812.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,630.27 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $316.23 Median $575.44 Typical High $933.25 | Professional | None | $316.23 | $575.44 | $933.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $602.56 | Professional | None | $257.04 | $389.05 | $602.56 |
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 $169.82 Median $208.93 Typical High $257.04 | Professional | 52 · Reduced service | $169.82 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $83.18 Typical High $102.33 | Professional | 53 · Discontinued | $67.61 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $389.05 | Professional | 54 · Surgery only | $251.19 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $77.62 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $41.69 Typical High $51.29 | Professional | 56 · Pre-op care only | $33.88 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $363.08 |
Where New Jersey sits
The same service costs 5.3 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 $6,378MT $1,213
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.