How much rates vary
Facilitymedian $3,890 · 10th to 90th $955 to $9,772Professionalmedian $389 · 10th to 90th $288 to $891
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 $363.08 Median $4,570.88 Typical High $10,471.29 | Facility | None | $363.08 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $676.08 | Professional | None | $363.08 | $389.05 | $676.08 |
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 $323.59 Median $398.11 Typical High $977.24 | Professional | None | $323.59 | $398.11 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $537.03 | Professional | None | $363.08 | $537.03 | $537.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,754.23 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $1,023.29 | Professional | None | $354.81 | $416.87 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $891.25 | Professional | None | $229.09 | $323.59 | $891.25 |
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 $181.97 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $302.00 |
Where New Jersey sits
The same service costs 5.9 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 $6,847MT $1,164
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.