How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,047 to $10,715Professionalmedian $631 · 10th to 90th $490 to $1,288
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 $489.78 Median $6,760.83 Typical High $12,022.64 | Facility | None | $489.78 | $6,760.83 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $1,122.02 | Professional | None | $489.78 | $524.81 | $1,122.02 |
AmeriHealth Setting Facility Modifier None Typical Low $5,495.41 Median $9,332.54 Typical High $19,952.62 | Facility | None | $5,495.41 | $9,332.54 | $19,952.62 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $4,168.69 | Facility | None | $1,445.44 | $2,754.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $1,380.38 | Professional | None | $537.03 | $602.56 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $870.96 | Professional | None | $602.56 | $870.96 | $870.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,570.88 Typical High $13,182.57 | Facility | None | $2,511.89 | $4,570.88 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,479.11 | Professional | None | $537.03 | $630.96 | $1,479.11 |
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 $512.86 Median $691.83 Typical High $1,288.25 | Professional | None | $512.86 | $691.83 | $1,288.25 |
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 $245.47 Median $245.47 Typical High $331.13 | Professional | 52 · Reduced service | $245.47 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | 53 · Discontinued | $97.72 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | 54 · Surgery only | $363.08 | $363.08 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $457.09 |
Where New Jersey sits
The same service costs 3.6 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 $6,446MT $1,806
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.