How much rates vary
Facilitymedian $2,818 · 10th to 90th $933 to $8,511Professionalmedian $339 · 10th to 90th $263 to $776
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 $323.59 Median $6,760.83 Typical High $10,964.78 | Facility | None | $323.59 | $6,760.83 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $602.56 | Professional | None | $323.59 | $346.74 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,819.70 Typical High $3,388.44 | Facility | None | $977.24 | $1,819.70 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $851.14 | Professional | None | $288.40 | $354.81 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $478.63 | Professional | None | $323.59 | $478.63 | $478.63 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $8,511.38 | Facility | None | $1,584.89 | $2,818.38 | $8,511.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $912.01 | Professional | None | $309.03 | $363.08 | $912.01 |
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 $204.17 Median $281.84 Typical High $776.25 | Professional | None | $204.17 | $281.84 | $776.25 |
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 $162.18 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $263.03 |
Where New Jersey sits
The same service costs 5.1 times more in Oklahoma 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
OK $5,094MT $991
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.