How much rates vary
Facilitymedian $3,090 · 10th to 90th $724 to $8,511Professionalmedian $339 · 10th to 90th $234 to $562
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 $275.42 Median $5,888.44 Typical High $10,471.29 | Facility | None | $275.42 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $436.52 | Professional | None | $275.42 | $398.11 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,174.90 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $660.69 | Professional | None | $269.15 | $398.11 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | None | $478.63 | $645.65 | $645.65 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $13,182.57 | Facility | None | $2,630.27 | $4,786.30 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $794.33 | Professional | None | $257.04 | $489.78 | $794.33 |
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 $208.93 Median $309.03 Typical High $501.19 | Professional | None | $208.93 | $309.03 | $501.19 |
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 $138.04 Median $177.83 Typical High $218.78 | Professional | 52 · Reduced service | $138.04 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $70.79 Typical High $87.10 | Professional | 53 · Discontinued | $54.95 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $204.17 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $52.48 Typical High $66.07 | Professional | 55 · Aftercare only | $40.74 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $245.47 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $190.55 | $245.47 | $302.00 |
Where New Jersey sits
The same service costs 6.3 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 $6,296MT $1,002
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.