How much rates vary
Facilitymedian $851 · 10th to 90th $186 to $4,786Professionalmedian $219 · 10th to 90th $117 to $427
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 $144.54 Median $3,311.31 Typical High $10,000.00 | Facility | None | $144.54 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $302.00 | Professional | None | $134.90 | $218.78 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $309.03 Typical High $1,659.59 | Facility | None | $165.96 | $309.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $436.52 | Professional | None | $123.03 | $218.78 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | None | $275.42 | $407.38 | $407.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $208.93 Median $371.54 Typical High $1,023.29 | Facility | None | $208.93 | $371.54 | $1,023.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $562.34 | Professional | None | $128.82 | $245.47 | $562.34 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $416.87 | Professional | None | $95.50 | $186.21 | $416.87 |
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 $67.61 Median $97.72 Typical High $109.65 | Professional | 52 · Reduced service | $67.61 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $26.92 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $147.91 Typical High $165.96 | Professional | 54 · Surgery only | $102.33 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $29.51 Typical High $33.11 | Professional | 55 · Aftercare only | $20.42 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.49 | $19.95 | $21.88 |
Where New Jersey sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.