How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,259 to $9,333Professionalmedian $513 · 10th to 90th $380 to $832
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 $575.44 Median $6,918.31 Typical High $11,748.98 | Facility | None | $575.44 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $630.96 | Professional | None | $512.86 | $512.86 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,318.26 | $2,754.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $933.25 | Professional | None | $398.11 | $478.63 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,000.00 | Professional | None | $660.69 | $912.01 | $1,000.00 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $5,495.41 Typical High $13,489.63 | Facility | None | $3,090.30 | $5,495.41 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $912.01 | Professional | None | $575.44 | $676.08 | $912.01 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $630.96 | Professional | None | $354.81 | $426.58 | $630.96 |
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 $257.04 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $416.87 |
Where New Jersey sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.