How much rates vary
Facilitymedian $2,138 · 10th to 90th $794 to $6,607Professionalmedian $240 · 10th to 90th $145 to $363
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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | None | $302.00 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,380.38 Typical High $3,311.31 | Facility | None | $724.44 | $1,380.38 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $389.05 | Professional | None | $165.96 | $199.53 | $389.05 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $380.19 | Professional | None | $257.04 | $346.74 | $380.19 |
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 $239.88 Median $281.84 Typical High $389.05 | Professional | None | $239.88 | $281.84 | $389.05 |
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 $134.90 Median $173.78 Typical High $269.15 | Professional | None | $134.90 | $173.78 | $269.15 |
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 $151.36 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $45.71 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $35.48 | $35.48 |
Where New Jersey sits
The same service costs 5.6 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 $4,320MT $769
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.