How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,047 to $10,233Professionalmedian $245 · 10th to 90th $170 to $537
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 $213.80 Median $5,248.07 Typical High $10,471.29 | Facility | None | $213.80 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $467.74 | Professional | None | $213.80 | $245.47 | $467.74 |
AmeriHealth Setting Facility Modifier None Typical Low $3,630.78 Median $9,332.54 Typical High $16,982.44 | Facility | None | $3,630.78 | $9,332.54 | $16,982.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $3,715.35 | Facility | None | $933.25 | $2,238.72 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $616.60 | Professional | None | $165.96 | $281.84 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $331.13 | Professional | None | $229.09 | $331.13 | $331.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $14,125.38 | Facility | None | $2,691.53 | $4,677.35 | $14,125.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $691.83 | Professional | None | $229.09 | $275.42 | $691.83 |
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 $158.49 Median $218.78 Typical High $537.03 | Professional | None | $158.49 | $218.78 | $537.03 |
5 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 $107.15 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $107.15 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $53.70 | Professional | 53 · Discontinued | $42.66 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $199.53 | Professional | 54 · Surgery only | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $26.92 |
Where New Jersey sits
The same service costs 8.5 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 $6,252MT $735
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.