How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,288 to $9,772Professionalmedian $813 · 10th to 90th $631 to $1,905
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 $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $954.99 | Professional | None | $630.96 | $630.96 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $6,025.60 | Facility | None | $691.83 | $3,162.28 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $2,089.30 | Professional | None | $691.83 | $851.14 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $776.25 | $1,148.15 | $1,148.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,585.78 Typical High $21,877.62 | Facility | None | $4,168.69 | $7,585.78 | $21,877.62 |
Horizon BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $2,089.30 | Professional | None | $758.58 | $891.25 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,905.46 | Professional | None | $512.86 | $758.58 | $1,905.46 |
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 $309.03 Median $309.03 Typical High $478.63 | Professional | 52 · Reduced service | $309.03 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $190.55 | Professional | 53 · Discontinued | $125.89 | $125.89 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | 54 · Surgery only | $467.74 | $467.74 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $144.54 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $660.69 |
Where New Jersey sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.