How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,202 to $14,791Professionalmedian $646 · 10th to 90th $427 to $912
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 $645.65 Median $6,918.31 Typical High $12,022.64 | Facility | None | $645.65 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | None | $645.65 | $645.65 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $8,912.51 Typical High $16,218.10 | Facility | None | $1,995.26 | $8,912.51 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $1,071.52 | Professional | None | $436.52 | $524.81 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,096.48 | Professional | None | $794.33 | $1,000.00 | $1,096.48 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $10,471.29 Typical High $39,810.72 | Facility | None | $5,754.40 | $10,471.29 | $39,810.72 |
Horizon BCBS Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $1,000.00 | Professional | None | $724.44 | $741.31 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,786.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $707.95 | Professional | None | $389.05 | $489.78 | $707.95 |
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 $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $97.72 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $457.09 |
Where New Jersey sits
The same service costs 8.1 times more in Alaska 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
AK $17,082MT $2,120
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.