How much rates vary
Facilitymedian $2,138 · 10th to 90th $309 to $6,607Professionalmedian $191 · 10th to 90th $117 to $380
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 $141.25 Median $3,548.13 Typical High $10,000.00 | Facility | None | $141.25 | $3,548.13 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $245.47 | Professional | None | $128.82 | $190.55 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,621.81 Typical High $2,570.40 | Facility | None | $691.83 | $1,621.81 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $426.58 | Professional | None | $120.23 | $194.98 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $331.13 | Professional | None | $218.78 | $331.13 | $331.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,019.95 Typical High $8,317.64 | Facility | None | $1,659.59 | $3,019.95 | $8,317.64 |
Horizon BCBS Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $489.78 | Professional | None | $125.89 | $218.78 | $489.78 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $371.54 | Professional | None | $91.20 | $154.88 | $371.54 |
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 $64.57 Median $87.10 Typical High $97.72 | Professional | 52 · Reduced service | $64.57 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $34.67 Typical High $38.90 | Professional | 53 · Discontinued | $25.70 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $131.83 Typical High $144.54 | Professional | 54 · Surgery only | $95.50 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.30 Typical High $28.84 | Professional | 55 · Aftercare only | $19.05 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.38 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.88 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $123.03 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $89.13 | $123.03 | $134.90 |
Where New Jersey sits
The same service costs 9.9 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 $4,605MT $466
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.