How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $8,511Professionalmedian $363 · 10th to 90th $219 to $562
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 $389.05 Median $5,888.44 Typical High $10,471.29 | Facility | None | $389.05 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
AmeriHealth Setting Facility Modifier None Typical Low $3,162.28 Median $8,317.64 Typical High $16,982.44 | Facility | None | $3,162.28 | $8,317.64 | $16,982.44 |
AmeriHealth Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $831.76 | Professional | None | $407.38 | $478.63 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $6,456.54 | Facility | None | $954.99 | $1,819.70 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $691.83 | Professional | None | $245.47 | $295.12 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $575.44 | Professional | None | $380.19 | $512.86 | $575.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,570.88 Typical High $7,762.47 | Facility | None | $2,630.27 | $4,570.88 | $7,762.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $575.44 | Professional | None | $354.81 | $426.58 | $575.44 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $398.11 | Professional | None | $204.17 | $263.03 | $398.11 |
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 $194.98 Median $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $39.81 |
Where New Jersey sits
The same service costs 5.0 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 $5,749MT $1,151
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.