How much rates vary
Facilitymedian $2,754 · 10th to 90th $955 to $8,511Professionalmedian $302 · 10th to 90th $234 to $708
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 $234.42 Median $6,760.83 Typical High $11,481.54 | Facility | None | $234.42 | $6,760.83 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $549.54 | Professional | None | $234.42 | $275.42 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,819.70 Typical High $3,388.44 | Facility | None | $977.24 | $1,819.70 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $776.25 | Professional | None | $263.03 | $338.84 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | None | $295.12 | $436.52 | $436.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $7,943.28 | Facility | None | $1,513.56 | $2,754.23 | $7,943.28 |
Horizon BCBS Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $794.33 | Professional | None | $281.84 | $331.13 | $794.33 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $707.95 | Professional | None | $204.17 | $281.84 | $707.95 |
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 $117.49 Median $117.49 Typical High $177.83 | Professional | 52 · Reduced service | $117.49 | $117.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $70.79 | Professional | 53 · Discontinued | $47.86 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $263.03 | Professional | 54 · Surgery only | $177.83 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $52.48 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $245.47 |
Where New Jersey sits
The same service costs 6.6 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 $6,126MT $925
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.