How much rates vary
Facilitymedian $1,905 · 10th to 90th $692 to $6,310Professionalmedian $162 · 10th to 90th $102 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 $234.42 Median $4,786.30 Typical High $10,471.29 | Facility | None | $234.42 | $4,786.30 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $234.42 | Professional | None | $204.17 | $229.09 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,148.15 Typical High $1,778.28 | Facility | None | $691.83 | $1,148.15 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $346.74 | Professional | None | $112.20 | $134.90 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $263.03 | Professional | None | $177.83 | $239.88 | $263.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $4,466.84 | Facility | None | $1,047.13 | $1,905.46 | $4,466.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $295.12 | Professional | None | $158.49 | $190.55 | $295.12 |
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 $93.33 Median $123.03 Typical High $199.53 | Professional | None | $93.33 | $123.03 | $199.53 |
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 $112.20 Typical High $117.49 | Professional | 52 · Reduced service | $102.33 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $46.77 | Professional | 53 · Discontinued | $40.74 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $169.82 Typical High $177.83 | Professional | 54 · Surgery only | $151.36 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $35.48 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $23.44 |
Where New Jersey sits
The same service costs 7.7 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 $4,047MT $526
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.