How much rates vary
Facilitymedian $3,236 · 10th to 90th $977 to $9,120Professionalmedian $200 · 10th to 90th $162 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 $181.97 Median $5,248.07 Typical High $10,471.29 | Facility | None | $181.97 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $338.84 | Professional | None | $162.18 | $181.97 | $338.84 |
AmeriHealth Setting Facility Modifier None Typical Low $2,344.23 Median $9,549.93 Typical High $19,952.62 | Facility | None | $2,344.23 | $9,549.93 | $19,952.62 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $3,890.45 | Facility | None | $933.25 | $2,290.87 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $457.09 | Professional | None | $162.18 | $208.93 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $309.03 | Professional | None | $177.83 | $257.04 | $309.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $12,302.69 | Facility | None | $2,691.53 | $4,786.30 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $489.78 | Professional | None | $173.78 | $204.17 | $489.78 |
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 $162.18 Median $213.80 Typical High $416.87 | Professional | None | $162.18 | $213.80 | $416.87 |
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 $85.11 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $85.11 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $33.88 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $128.82 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $125.89 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $120.23 | $125.89 | $147.91 |
Where New Jersey sits
The same service costs 8.1 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 $4,634MT $570
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.