How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,820 to $11,482Professionalmedian $1,349 · 10th to 90th $871 to $3,162
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 $3,801.89 Median $7,943.28 Typical High $12,022.64 | Facility | None | $3,801.89 | $7,943.28 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,348.96 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,981.07 Typical High $6,760.83 | Facility | None | $1,513.56 | $3,981.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,348.96 Typical High $2,951.21 | Professional | None | $812.83 | $1,348.96 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,584.89 | $2,398.83 | $2,398.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,511.38 Typical High $22,387.21 | Facility | None | $4,786.30 | $8,511.38 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $4,168.69 | Professional | None | $1,148.15 | $1,698.24 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $3,388.44 | Professional | None | $776.25 | $1,202.26 | $3,388.44 |
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 $575.44 Median $676.08 Typical High $776.25 | Professional | 52 · Reduced service | $575.44 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $269.15 Typical High $309.03 | Professional | 53 · Discontinued | $229.09 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $851.14 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $154.88 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $794.33 | $954.99 | $1,071.52 |
Where New Jersey sits
The same service costs 3.2 times more in Alaska 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
AK $12,311KY $3,892
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.