How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,585 to $10,965Professionalmedian $1,047 · 10th to 90th $794 to $2,344
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 $1,023.29 Median $6,918.31 Typical High $11,748.98 | Facility | None | $1,023.29 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,905.46 | Professional | None | $933.25 | $1,023.29 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,715.35 Typical High $6,760.83 | Facility | None | $1,995.26 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $2,454.71 | Professional | None | $758.58 | $1,174.90 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,621.81 | $1,621.81 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $22,387.21 | Facility | None | $4,677.35 | $8,511.38 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $3,019.95 | Professional | None | $1,023.29 | $1,230.27 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $2,344.23 | Professional | None | $758.58 | $1,000.00 | $2,344.23 |
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 $467.74 Median $467.74 Typical High $588.84 | Professional | 52 · Reduced service | $467.74 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $234.42 | Professional | 53 · Discontinued | $186.21 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $891.25 | Professional | 54 · Surgery only | $707.95 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $177.83 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $831.76 |
Where New Jersey sits
The same service costs 3.4 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 $11,546MT $3,436
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.