How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,995 to $12,882Professionalmedian $562 · 10th to 90th $427 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 $4,466.84 Median $6,918.31 Typical High $11,748.98 | Facility | None | $4,466.84 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $562.34 | Professional | None | $549.54 | $549.54 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $4,466.84 Typical High $8,511.38 | Facility | None | $1,174.90 | $4,466.84 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $1,148.15 | Professional | None | $524.81 | $616.60 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $831.76 | Professional | None | $616.60 | $831.76 | $831.76 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $10,471.29 Typical High $27,542.29 | Facility | None | $5,495.41 | $10,471.29 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $933.25 | Professional | None | $575.44 | $616.60 | $933.25 |
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 $389.05 Median $489.78 Typical High $758.58 | Professional | None | $389.05 | $489.78 | $758.58 |
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 $275.42 Typical High $281.84 | Professional | 52 · Reduced service | $269.15 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $407.38 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $81.28 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $380.19 | $389.05 | $389.05 |
Where New Jersey sits
The same service costs 7.9 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 $13,941MT $1,762
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.