How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,995 to $12,023Professionalmedian $955 · 10th to 90th $741 to $2,239
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 $4,466.84 Median $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,698.24 | Professional | None | $741.31 | $933.25 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $6,165.95 Typical High $11,220.18 | Facility | None | $2,238.72 | $6,165.95 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $2,454.71 | Professional | None | $812.83 | $1,000.00 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,288.25 | Professional | None | $870.96 | $1,288.25 | $1,288.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $8,317.64 Typical High $43,651.58 | Facility | None | $4,365.16 | $8,317.64 | $43,651.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $2,398.83 | Professional | None | $870.96 | $1,023.29 | $2,398.83 |
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 $602.56 Median $870.96 Typical High $2,238.72 | Professional | None | $602.56 | $870.96 | $2,238.72 |
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 $371.54 Median $371.54 Typical High $562.34 | Professional | 52 · Reduced service | $371.54 | $371.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $223.87 | Professional | 53 · Discontinued | $147.91 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $831.76 | Professional | 54 · Surgery only | $562.34 | $562.34 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $169.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $776.25 |
Where New Jersey sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.