How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,047 to $7,762Professionalmedian $437 · 10th to 90th $339 to $933
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 $426.58 Median $5,623.41 Typical High $10,471.29 | Facility | None | $426.58 | $5,623.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $512.86 | Professional | None | $354.81 | $426.58 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,137.96 Typical High $3,311.31 | Facility | None | $933.25 | $2,137.96 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $1,047.13 | Professional | None | $331.13 | $489.78 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $707.95 | Professional | None | $467.74 | $707.95 | $707.95 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $12,589.25 | Facility | None | $2,187.76 | $3,801.89 | $12,589.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $1,258.93 | Professional | None | $426.58 | $512.86 | $1,258.93 |
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 $323.59 Median $426.58 Typical High $1,000.00 | Professional | None | $323.59 | $426.58 | $1,000.00 |
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 $177.83 Median $177.83 Typical High $257.04 | Professional | 52 · Reduced service | $177.83 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $102.33 | Professional | 53 · Discontinued | $70.79 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $380.19 | Professional | 54 · Surgery only | $263.03 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $75.86 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $354.81 |
Where New Jersey sits
The same service costs 3.6 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 $5,175MT $1,450
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.