How much rates vary
Facilitymedian $2,138 · 10th to 90th $676 to $6,918Professionalmedian $174 · 10th to 90th $107 to $257
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 $190.55 Median $5,248.07 Typical High $10,471.29 | Facility | None | $190.55 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $190.55 | Professional | None | $186.21 | $186.21 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,290.87 | Facility | None | $741.31 | $1,584.89 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $323.59 | Professional | None | $120.23 | $144.54 | $323.59 |
Emblem Health Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $281.84 | Professional | None | $186.21 | $257.04 | $281.84 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,511.89 Typical High $7,762.47 | Facility | None | $1,380.38 | $2,511.89 | $7,762.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $281.84 | Professional | None | $173.78 | $204.17 | $281.84 |
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 $100.00 Median $128.82 Typical High $190.55 | Professional | None | $100.00 | $128.82 | $190.55 |
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 $93.33 Median $93.33 Typical High $95.50 | Professional | 52 · Reduced service | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | 53 · Discontinued | $37.15 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 54 · Surgery only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $19.05 |
Where New Jersey sits
The same service costs 7.3 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 $4,136MT $564
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.