How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,122 to $7,586Professionalmedian $295 · 10th to 90th $162 to $661
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 $2,754.23 Median $5,754.40 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,754.40 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $467.74 | Professional | None | $162.18 | $234.42 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,698.24 Typical High $2,511.89 | Facility | None | $831.76 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $660.69 | Professional | None | $181.97 | $331.13 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $537.03 | Professional | None | $354.81 | $537.03 | $537.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $8,511.38 | Facility | None | $1,584.89 | $2,818.38 | $8,511.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $190.55 Median $380.19 Typical High $758.58 | Professional | None | $190.55 | $380.19 | $758.58 |
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 $151.36 Median $281.84 Typical High $630.96 | Professional | None | $151.36 | $281.84 | $630.96 |
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 $81.28 Median $117.49 Typical High $165.96 | Professional | 52 · Reduced service | $81.28 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $33.11 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $251.19 | Professional | 54 · Surgery only | $123.03 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $35.48 Typical High $50.12 | Professional | 55 · Aftercare only | $24.55 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.44 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.22 | $23.44 | $33.11 |
Where New Jersey sits
The same service costs 7.9 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 $5,867MT $745
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.