How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,047 to $10,471Professionalmedian $347 · 10th to 90th $269 to $794
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 $331.13 Median $6,309.57 Typical High $10,471.29 | Facility | None | $331.13 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $645.65 | Professional | None | $331.13 | $346.74 | $645.65 |
AmeriHealth Setting Facility Modifier None Typical Low $4,265.80 Median $9,549.93 Typical High $19,952.62 | Facility | None | $4,265.80 | $9,549.93 | $19,952.62 |
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 $295.12 Median $363.08 Typical High $870.96 | Professional | None | $295.12 | $363.08 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $489.78 | Professional | None | $331.13 | $489.78 | $489.78 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $13,182.57 | Facility | None | $2,630.27 | $4,786.30 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $933.25 | Professional | None | $316.23 | $371.54 | $933.25 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $794.33 | Professional | None | $208.93 | $288.40 | $794.33 |
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 $165.96 Median $165.96 Typical High $194.98 | Professional | 52 · Reduced service | $165.96 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $77.62 | Professional | 53 · Discontinued | $66.07 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 54 · Surgery only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $269.15 |
Where New Jersey sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.