How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,023 to $8,913Professionalmedian $355 · 10th to 90th $245 to $776
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 $302.00 Median $6,760.83 Typical High $10,964.78 | Facility | None | $302.00 | $6,760.83 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $660.69 | Professional | None | $302.00 | $354.81 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $3,890.45 | Facility | None | $1,659.59 | $2,754.23 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $870.96 | Professional | None | $239.88 | $407.38 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $478.63 | Professional | None | $346.74 | $478.63 | $478.63 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $14,125.38 | Facility | None | $2,630.27 | $4,677.35 | $14,125.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $1,000.00 | Professional | None | $331.13 | $407.38 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $776.25 | Professional | None | $229.09 | $316.23 | $776.25 |
3 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 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | 54 · Surgery only | $229.09 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $38.90 |
Where New Jersey sits
The same service costs 6.7 times more in Oklahoma 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
OK $7,024MT $1,050
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.