How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,122 to $12,882Professionalmedian $813 · 10th to 90th $603 to $1,288
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 $812.83 Median $6,918.31 Typical High $11,748.98 | Facility | None | $812.83 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | None | $812.83 | $812.83 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $6,760.83 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,760.83 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,659.59 | Professional | None | $758.58 | $870.96 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | None | $870.96 | $1,174.90 | $1,174.90 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $7,762.47 Typical High $27,542.29 | Facility | None | $4,265.80 | $7,762.47 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,380.38 | Professional | None | $831.76 | $891.25 | $1,380.38 |
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 $549.54 Median $691.83 Typical High $1,122.02 | Professional | None | $549.54 | $691.83 | $1,122.02 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where New Jersey sits
The same service costs 5.9 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 $14,644MT $2,489
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.