How much rates vary
Facilitymedian $3,090 · 10th to 90th $708 to $8,511Professionalmedian $490 · 10th to 90th $347 to $832
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 $416.87 Median $5,623.41 Typical High $10,471.29 | Facility | None | $416.87 | $5,623.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $602.56 | Professional | None | $398.11 | $549.54 | $602.56 |
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 $407.38 Median $549.54 Typical High $933.25 | Professional | None | $407.38 | $549.54 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $933.25 | Professional | None | $676.08 | $933.25 | $933.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,511.89 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $398.11 Median $676.08 Typical High $1,122.02 | Professional | None | $398.11 | $676.08 | $1,122.02 |
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 $295.12 Median $446.68 Typical High $724.44 | Professional | None | $295.12 | $446.68 | $724.44 |
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 $199.53 Median $245.47 Typical High $302.00 | Professional | 52 · Reduced service | $199.53 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $79.43 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $295.12 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $58.88 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $39.81 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $275.42 | $354.81 | $416.87 |
Where New Jersey sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.