How much rates vary
Facilitymedian $3,090 · 10th to 90th $955 to $8,511Professionalmedian $513 · 10th to 90th $372 to $1,202
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 $398.11 Median $6,309.57 Typical High $10,471.29 | Facility | None | $398.11 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $912.01 | Professional | None | $398.11 | $524.81 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,981.07 | Facility | None | $1,174.90 | $2,570.40 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $1,318.26 | Professional | None | $436.52 | $549.54 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $562.34 | Professional | None | $380.19 | $562.34 | $562.34 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $5,011.87 Typical High $14,454.40 | Facility | None | $2,754.23 | $5,011.87 | $14,454.40 |
Horizon BCBS Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $1,318.26 | Professional | None | $467.74 | $549.54 | $1,318.26 |
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 $281.84 Median $436.52 Typical High $1,202.26 | Professional | None | $281.84 | $436.52 | $1,202.26 |
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 $199.53 Median $199.53 Typical High $295.12 | Professional | 52 · Reduced service | $199.53 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $120.23 | Professional | 53 · Discontinued | $79.43 | $79.43 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $446.68 | Professional | 54 · Surgery only | $295.12 | $295.12 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $89.13 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $58.88 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $416.87 |
Where New Jersey sits
The same service costs 5.6 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 $7,579MT $1,353
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.