How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,230 to $7,943Professionalmedian $457 · 10th to 90th $309 to $955
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 $3,890.45 Median $5,888.44 Typical High $10,471.29 | Facility | None | $3,890.45 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $831.76 | Professional | None | $363.08 | $407.38 | $831.76 |
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 $302.00 Median $501.19 Typical High $1,023.29 | Professional | None | $302.00 | $501.19 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $645.65 | Professional | None | $457.09 | $645.65 | $645.65 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $3,801.89 Typical High $13,489.63 | Facility | None | $2,041.74 | $3,801.89 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $1,230.27 | Professional | None | $416.87 | $501.19 | $1,230.27 |
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 $302.00 Median $398.11 Typical High $977.24 | Professional | None | $302.00 | $398.11 | $977.24 |
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 $181.97 Median $181.97 Typical High $239.88 | Professional | 52 · Reduced service | $181.97 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $363.08 | Professional | 54 · Surgery only | $275.42 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $338.84 |
Where New Jersey sits
The same service costs 4.1 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 $5,653MT $1,368
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.