How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,862 to $50,119Professionalmedian $1,000 · 10th to 90th $813 to $2,291
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 $977.24 Median $8,128.31 Typical High $17,378.01 | Facility | None | $977.24 | $8,128.31 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,698.24 | Professional | None | $776.25 | $1,000.00 | $1,698.24 |
AmeriHealth Setting Facility Modifier None Typical Low $2,570.40 Median $9,120.11 Typical High $79,432.82 | Facility | None | $2,570.40 | $9,120.11 | $79,432.82 |
AmeriHealth Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,737.80 | Professional | None | $891.25 | $1,148.15 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $30,902.95 Typical High $50,118.72 | Facility | None | $1,995.26 | $30,902.95 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $2,344.23 | Professional | None | $891.25 | $933.25 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,288.25 | Professional | None | $891.25 | $1,258.93 | $1,288.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $25,703.96 Typical High $97,723.72 | Facility | None | $12,022.64 | $25,703.96 | $97,723.72 |
Horizon BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,630.27 | Professional | None | $891.25 | $1,047.13 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $9,332.54 Typical High $47,863.01 | Facility | None | $1,905.46 | $9,332.54 | $47,863.01 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $2,754.23 | Professional | None | $812.83 | $1,023.29 | $2,754.23 |
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 $489.78 Median $501.19 Typical High $512.86 | Professional | 52 · Reduced service | $489.78 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $194.98 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $776.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $724.44 |
Where New Jersey sits
The same service costs 19.9 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 $53,750MT $2,699
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.