How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,023 to $8,128Professionalmedian $219 · 10th to 90th $170 to $513
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 $223.87 Median $4,786.30 Typical High $10,964.78 | Facility | None | $223.87 | $4,786.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $389.05 | Professional | None | $213.80 | $213.80 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $3,801.89 | Facility | None | $691.83 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $562.34 | Professional | None | $186.21 | $239.88 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $309.03 | Professional | None | $208.93 | $309.03 | $309.03 |
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 $204.17 Median $239.88 Typical High $588.84 | Professional | None | $204.17 | $239.88 | $588.84 |
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 $131.83 Median $186.21 Typical High $512.86 | Professional | None | $131.83 | $186.21 | $512.86 |
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 $107.15 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $107.15 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $43.65 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $173.78 |
Where New Jersey sits
The same service costs 9.6 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 $6,197MT $647
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.