How much rates vary
Facilitymedian $3,090 · 10th to 90th $759 to $9,120Professionalmedian $646 · 10th to 90th $155 to $1,585
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 $218.78 Median $4,466.84 Typical High $9,772.37 | Facility | None | $218.78 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $724.44 Typical High $1,174.90 | Professional | None | $138.04 | $724.44 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
AmeriHealth Setting Facility Modifier None Typical Low $2,344.23 Median $9,549.93 Typical High $19,952.62 | Facility | None | $2,344.23 | $9,549.93 | $19,952.62 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,344.23 Typical High $3,981.07 | Facility | None | $933.25 | $2,344.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $707.95 Typical High $1,698.24 | Professional | None | $177.83 | $707.95 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,258.93 | Professional | None | $812.83 | $1,258.93 | $1,258.93 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,630.27 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $194.98 Median $912.01 Typical High $1,995.26 | Professional | None | $194.98 | $912.01 | $1,995.26 |
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 $141.25 Median $501.19 Typical High $1,513.56 | Professional | None | $141.25 | $501.19 | $1,513.56 |
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 $69.18 Median $309.03 Typical High $407.38 | Professional | 52 · Reduced service | $69.18 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $123.03 Typical High $165.96 | Professional | 53 · Discontinued | $27.54 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $457.09 Typical High $616.60 | Professional | 54 · Surgery only | $104.71 | $457.09 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $93.33 Typical High $123.03 | Professional | 55 · Aftercare only | $20.89 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $61.66 Typical High $81.28 | Professional | 56 · Pre-op care only | $13.80 | $61.66 | $81.28 |
Where New Jersey sits
The same service costs 3.8 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 $5,124MT $1,344
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.