How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,047 to $10,715Professionalmedian $759 · 10th to 90th $562 to $1,698
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 $645.65 Median $6,309.57 Typical High $10,471.29 | Facility | None | $645.65 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,630.78 Typical High $6,760.83 | Facility | None | $1,174.90 | $3,630.78 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,862.09 | Professional | None | $562.34 | $812.83 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,148.15 | Professional | None | $831.76 | $1,148.15 | $1,148.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,511.38 Typical High $23,988.33 | Facility | None | $4,466.84 | $8,511.38 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $2,187.76 | Professional | None | $741.31 | $912.01 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,737.80 | Professional | None | $549.54 | $707.95 | $1,737.80 |
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 $323.59 Median $323.59 Typical High $436.52 | Professional | 52 · Reduced service | $323.59 | $323.59 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | 53 · Discontinued | $128.82 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | 54 · Surgery only | $489.78 | $489.78 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $87.10 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $616.60 |
Where New Jersey sits
The same service costs 4.2 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 $10,315MT $2,461
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.