How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,445 to $9,772Professionalmedian $1,445 · 10th to 90th $1,122 to $3,388
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 $1,348.96 Median $4,570.88 Typical High $11,748.98 | Facility | None | $1,348.96 | $4,570.88 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,348.96 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,890.45 Typical High $6,760.83 | Facility | None | $1,995.26 | $3,890.45 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $3,235.94 | Professional | None | $870.96 | $1,258.93 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,905.46 | $1,905.46 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $4,570.88 Typical High $22,387.21 | Facility | None | $2,344.23 | $4,570.88 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $3,801.89 | Professional | None | $1,258.93 | $1,479.11 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,318.26 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $3,981.07 | Professional | None | $1,174.90 | $1,479.11 | $3,981.07 |
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 $676.08 Median $676.08 Typical High $741.31 | Professional | 52 · Reduced service | $676.08 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,047.13 |
Where New Jersey sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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 $18,462KY $2,797
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.