How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,479 to $11,749Professionalmedian $794 · 10th to 90th $661 to $1,738
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 $724.44 Median $6,760.83 Typical High $12,022.64 | Facility | None | $724.44 | $6,760.83 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $1,412.54 | Professional | None | $660.69 | $724.44 | $1,412.54 |
AmeriHealth Setting Facility Modifier None Typical Low $3,388.44 Median $6,165.95 Typical High $9,332.54 | Facility | None | $3,388.44 | $6,165.95 | $9,332.54 |
AmeriHealth Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,548.82 | Professional | None | $660.69 | $831.76 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $4,073.80 Typical High $6,760.83 | Facility | None | $2,238.72 | $4,073.80 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,819.70 | Professional | None | $660.69 | $794.33 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | None | $724.44 | $1,047.13 | $1,047.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $6,309.57 Typical High $23,988.33 | Facility | None | $3,311.31 | $6,309.57 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $2,089.30 | Professional | None | $707.95 | $831.76 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,479.11 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,698.24 | Professional | None | $660.69 | $870.96 | $1,698.24 |
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 $354.81 Median $363.08 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $173.78 | Professional | 53 · Discontinued | $141.25 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $602.56 |
Where New Jersey sits
The same service costs 4.5 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 $10,099MT $2,245
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.