How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,230 to $13,804Professionalmedian $575 · 10th to 90th $447 to $891
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 $537.03 Median $6,760.83 Typical High $11,748.98 | Facility | None | $537.03 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $831.76 | Professional | None | $537.03 | $549.54 | $831.76 |
AmeriHealth Setting Facility Modifier None Typical Low $3,388.44 Median $8,317.64 Typical High $19,952.62 | Facility | None | $3,388.44 | $8,317.64 | $19,952.62 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $5,495.41 Typical High $10,471.29 | Facility | None | $1,318.26 | $5,495.41 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,202.26 | Professional | None | $537.03 | $630.96 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | None | $645.65 | $870.96 | $870.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $8,912.51 Typical High $27,542.29 | Facility | None | $4,365.16 | $8,912.51 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $870.96 | Professional | None | $588.84 | $630.96 | $870.96 |
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 $416.87 Median $501.19 Typical High $776.25 | Professional | None | $416.87 | $501.19 | $776.25 |
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 $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $380.19 |
Where New Jersey sits
The same service costs 7.5 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 $13,659MT $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.