How much rates vary
Facilitymedian $2,344 · 10th to 90th $575 to $8,318Professionalmedian $282 · 10th to 90th $129 to $603
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 $208.93 Median $4,466.84 Typical High $9,772.37 | Facility | None | $208.93 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $588.84 | Professional | None | $208.93 | $208.93 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
AmeriHealth Setting Facility Modifier None Typical Low $1,737.80 Median $7,762.47 Typical High $15,135.61 | Facility | None | $1,737.80 | $7,762.47 | $15,135.61 |
AmeriHealth Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $794.33 | Professional | None | $218.78 | $302.00 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,398.83 | Facility | None | $741.31 | $1,584.89 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $363.08 Typical High $645.65 | Professional | None | $151.36 | $363.08 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $245.47 Typical High $891.25 | Professional | None | $102.33 | $245.47 | $891.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,511.89 Typical High $7,244.36 | Facility | None | $1,380.38 | $2,511.89 | $7,244.36 |
Horizon BCBS Setting Professional Modifier None Typical Low $181.97 Median $512.86 Typical High $741.31 | Professional | None | $181.97 | $512.86 | $741.31 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $109.65 Median $295.12 Typical High $478.63 | Professional | None | $109.65 | $295.12 | $478.63 |
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 $102.33 Median $102.33 Typical High $257.04 | Professional | 52 · Reduced service | $102.33 | $102.33 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $102.33 | Professional | 53 · Discontinued | $41.69 | $41.69 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $389.05 | Professional | 54 · Surgery only | $154.88 | $154.88 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $77.62 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $51.29 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $51.29 |
Where New Jersey sits
The same service costs 4.1 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 $4,142MT $1,002
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.