How much rates vary
Facilitymedian $3,802 · 10th to 90th $575 to $10,471Professionalmedian $479 · 10th to 90th $324 to $776
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 $363.08 Median $4,677.35 Typical High $10,471.29 | Facility | None | $363.08 | $4,677.35 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $575.44 | Professional | None | $363.08 | $537.03 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,174.90 | $4,265.80 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $891.25 | Professional | None | $363.08 | $524.81 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $912.01 | Professional | None | $676.08 | $912.01 | $912.01 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $9,332.54 Typical High $27,542.29 | Facility | None | $5,248.07 | $9,332.54 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $1,047.13 | Professional | None | $346.74 | $645.65 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $660.69 | Professional | None | $281.84 | $436.52 | $660.69 |
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 $181.97 Median $234.42 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $93.33 Typical High $114.82 | Professional | 53 · Discontinued | $72.44 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $354.81 Typical High $426.58 | Professional | 54 · Surgery only | $275.42 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $85.11 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $57.54 | Professional | 56 · Pre-op care only | $36.31 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $331.13 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $257.04 | $331.13 | $398.11 |
Where New Jersey sits
The same service costs 6.4 times more in Alaska 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
AK $8,723MT $1,361
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.