How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,660 to $16,596Professionalmedian $4,266 · 10th to 90th $417 to $8,710
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 $478.63 Median $5,248.07 Typical High $10,471.29 | Facility | None | $478.63 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $4,265.80 Typical High $7,413.10 | Professional | None | $478.63 | $4,265.80 | $7,413.10 |
AmeriHealth Setting Facility Modifier None Typical Low $4,073.80 Median $9,549.93 Typical High $19,952.62 | Facility | None | $4,073.80 | $9,549.93 | $19,952.62 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $8,317.64 Typical High $15,135.61 | Facility | None | $1,995.26 | $8,317.64 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,174.90 Typical High $8,511.38 | Professional | None | $407.38 | $1,174.90 | $8,511.38 |
Emblem Health Setting Professional Modifier None Typical Low $4,570.88 Median $6,918.31 Typical High $7,413.10 | Professional | None | $4,570.88 | $6,918.31 | $7,413.10 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $13,489.63 Typical High $43,651.58 | Facility | None | $7,244.36 | $13,489.63 | $43,651.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $416.87 Median $6,025.60 Typical High $13,182.57 | Professional | None | $416.87 | $6,025.60 | $13,182.57 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,495.41 Typical High $13,803.84 | Facility | None | $1,659.59 | $5,495.41 | $13,803.84 |
United Setting Professional Modifier None Typical Low $407.38 Median $3,162.28 Typical High $8,912.51 | Professional | None | $407.38 | $3,162.28 | $8,912.51 |
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 $239.88 Median $1,000.00 Typical High $2,630.27 | Professional | 52 · Reduced service | $239.88 | $1,000.00 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $398.11 Typical High $1,047.13 | Professional | 53 · Discontinued | $95.50 | $398.11 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $1,479.11 Typical High $3,890.45 | Professional | 54 · Surgery only | $354.81 | $1,479.11 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $295.12 Typical High $776.25 | Professional | 55 · Aftercare only | $72.44 | $295.12 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $199.53 Typical High $524.81 | Professional | 56 · Pre-op care only | $47.86 | $199.53 | $524.81 |
Where New Jersey sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.