How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,202 to $7,762Professionalmedian $457 · 10th to 90th $288 to $851
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 $2,754.23 Median $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $630.96 | Professional | None | $371.54 | $501.19 | $630.96 |
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 $275.42 Median $436.52 Typical High $831.76 | Professional | None | $275.42 | $436.52 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $912.01 | Professional | None | $645.65 | $870.96 | $912.01 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $3,801.89 Typical High $12,589.25 | Facility | None | $2,041.74 | $3,801.89 | $12,589.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $380.19 Median $630.96 Typical High $1,000.00 | Professional | None | $380.19 | $630.96 | $1,000.00 |
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 $234.42 Median $380.19 Typical High $758.58 | Professional | None | $234.42 | $380.19 | $758.58 |
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 $186.21 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $186.21 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $100.00 Typical High $114.82 | Professional | 53 · Discontinued | $74.13 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $281.84 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $56.23 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $37.15 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $263.03 | $346.74 | $398.11 |
Where New Jersey sits
The same service costs 4.6 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 $6,614MT $1,440
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.