How much rates vary
Facilitymedian $1,698 · 10th to 90th $324 to $6,457Professionalmedian $105 · 10th to 90th $59 to $182
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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $173.78 | Professional | None | $93.33 | $134.90 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $2,137.96 Typical High $3,019.95 | Facility | None | $371.54 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $204.17 | Professional | None | $69.18 | $117.49 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | None | $177.83 | $245.47 | $245.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $257.04 | Professional | None | $87.10 | $165.96 | $257.04 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,412.54 Typical High $3,890.45 | Facility | None | $309.03 | $1,412.54 | $3,890.45 |
United Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $151.36 | Professional | None | $51.29 | $95.50 | $151.36 |
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 $46.77 Median $66.07 Typical High $87.10 | Professional | 52 · Reduced service | $46.77 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.30 Typical High $34.67 | Professional | 53 · Discontinued | $18.62 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $100.00 Typical High $128.82 | Professional | 54 · Surgery only | $70.79 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.95 Typical High $25.70 | Professional | 55 · Aftercare only | $14.13 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.18 Typical High $17.38 | Professional | 56 · Pre-op care only | $9.33 | $13.18 | $17.38 |
Where New Jersey sits
The same service costs 11.3 times more in Hawaii than in Delaware. 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
HI $2,996DE $264
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.