How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,096 to $21,380Professionalmedian $646 · 10th to 90th $479 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 $645.65 Median $6,760.83 Typical High $11,481.54 | Facility | None | $645.65 | $6,760.83 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | None | $630.96 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $10,964.78 Typical High $21,379.62 | Facility | None | $1,318.26 | $10,964.78 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,318.26 | Professional | None | $588.84 | $676.08 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $933.25 | Professional | None | $691.83 | $933.25 | $933.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $19,054.61 Typical High $52,480.75 | Facility | None | $10,000.00 | $19,054.61 | $52,480.75 |
Horizon BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,071.52 | Professional | None | $588.84 | $691.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $870.96 | Professional | None | $436.52 | $549.54 | $870.96 |
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 $309.03 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $309.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $123.03 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $457.09 |
Where New Jersey sits
The same service costs 10.1 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 $19,890MT $1,977
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.