How much rates vary
Facilitymedian $631 · 10th to 90th $204 to $1,950Professionalmedian $427 · 10th to 90th $275 to $2,951
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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $549.54 | Professional | None | $275.42 | $371.54 | $549.54 |
BCBS Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $741.31 | Professional | None | $309.03 | $446.68 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $1,659.59 | Facility | None | $331.13 | $426.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $588.84 | Professional | None | $275.42 | $363.08 | $588.84 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,548.13 | Professional | None | $2,951.21 | $2,951.21 | $3,548.13 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $691.83 | Professional | None | $302.00 | $407.38 | $691.83 |
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 $138.04 Median $186.21 Typical High $275.42 | Professional | 52 · Reduced service | $138.04 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $74.13 Typical High $109.65 | Professional | 53 · Discontinued | $54.95 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $281.84 Typical High $416.87 | Professional | 54 · Surgery only | $204.17 | $281.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $56.23 Typical High $83.18 | Professional | 55 · Aftercare only | $41.69 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $37.15 Typical High $54.95 | Professional | 56 · Pre-op care only | $27.54 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $263.03 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $190.55 | $263.03 | $389.05 |
Where Tennessee sits
The same service costs 4.5 times more in New York than in Florida. 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
NY $3,010FL $664
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.