How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,000 to $9,550Professionalmedian $162 · 10th to 90th $112 to $288
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 $6,606.93 Typical High $11,481.54 | Facility | None | $2,754.23 | $6,606.93 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $213.80 | Professional | None | $141.25 | $186.21 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,630.78 Typical High $6,760.83 | Facility | None | $1,513.56 | $3,630.78 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $309.03 | Professional | None | $112.20 | $162.18 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $398.11 | Professional | None | $288.40 | $398.11 | $398.11 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,511.38 Typical High $23,988.33 | Facility | None | $4,786.30 | $8,511.38 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $346.74 | Professional | None | $154.88 | $269.15 | $346.74 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,754.40 | Facility | None | $707.95 | $1,995.26 | $5,754.40 |
United Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $229.09 | Professional | None | $100.00 | $154.88 | $229.09 |
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 $69.18 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $69.18 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $28.18 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $104.71 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $20.89 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.62 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.13 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $97.72 | $128.82 | $147.91 |
Where New Jersey sits
The same service costs 11.8 times more in Wyoming 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
WY $6,811MT $578
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.