How much rates vary
Facilitymedian $2,399 · 10th to 90th $204 to $7,244Professionalmedian $155 · 10th to 90th $63 to $347
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 $77.62 Median $3,235.94 Typical High $9,772.37 | Facility | None | $77.62 | $3,235.94 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $263.03 | Professional | None | $74.13 | $173.78 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
AmeriHealth Setting Facility Modifier None Typical Low $831.76 Median $4,466.84 Typical High $11,748.98 | Facility | None | $831.76 | $4,466.84 | $11,748.98 |
AmeriHealth Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $602.56 | Professional | None | $67.61 | $93.33 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $2,884.03 | Facility | None | $1,230.27 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $151.36 Typical High $416.87 | Professional | None | $58.88 | $151.36 | $416.87 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $288.40 | Professional | None | $190.55 | $288.40 | $288.40 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,548.13 | $10,964.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $74.13 Median $204.17 Typical High $380.19 | Professional | None | $74.13 | $204.17 | $380.19 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $57.54 Median $147.91 Typical High $331.13 | Professional | None | $57.54 | $147.91 | $331.13 |
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 $38.90 Median $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $38.90 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $28.84 Typical High $37.15 | Professional | 53 · Discontinued | $15.49 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $57.54 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $11.48 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $14.45 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.76 | $14.45 | $18.20 |
Where New Jersey sits
The same service costs 9.7 times more in Colorado 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
CO $4,351MT $447
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.