How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,288 to $12,882Professionalmedian $1,122 · 10th to 90th $794 to $1,950
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 $1,096.48 Median $6,918.31 Typical High $13,489.63 | Facility | None | $1,096.48 | $6,918.31 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,122.02 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $933.25 Typical High $977.24 | Professional | None | $125.89 | $933.25 | $977.24 |
AmeriHealth Setting Facility Modifier None Typical Low $1,737.80 Median $3,388.44 Typical High $8,317.64 | Facility | None | $1,737.80 | $3,388.44 | $8,317.64 |
AmeriHealth Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,884.03 | Professional | None | $1,096.48 | $1,348.96 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $5,011.87 Typical High $8,511.38 | Facility | None | $1,513.56 | $5,011.87 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,174.90 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,548.82 | $1,548.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,912.51 Typical High $26,915.35 | Facility | None | $4,466.84 | $8,912.51 | $26,915.35 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,230.27 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $5,011.87 Typical High $11,748.98 | Facility | None | $1,621.81 | $5,011.87 | $11,748.98 |
United Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,513.56 | Professional | None | $741.31 | $954.99 | $1,513.56 |
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 $537.03 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $537.03 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $812.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $794.33 |
Where New Jersey sits
The same service costs 4.2 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 $14,362MT $3,396
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.