How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,202 to $10,471Professionalmedian $562 · 10th to 90th $407 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 $562.34 Median $6,309.57 Typical High $10,964.78 | Facility | None | $562.34 | $6,309.57 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | None | $562.34 | $562.34 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $3,981.07 Typical High $6,760.83 | Facility | None | $2,137.96 | $3,981.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $1,023.29 | Professional | None | $426.58 | $512.86 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,047.13 | Professional | None | $724.44 | $954.99 | $1,047.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $8,317.64 Typical High $22,908.68 | Facility | None | $4,570.88 | $8,317.64 | $22,908.68 |
Horizon BCBS Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $977.24 | Professional | None | $616.60 | $724.44 | $977.24 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $676.08 | Professional | None | $371.54 | $446.68 | $676.08 |
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 $281.84 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $281.84 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $446.68 |
Where New Jersey sits
The same service costs 5.4 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 $11,084MT $2,070
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.