How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,202 to $11,749Professionalmedian $676 · 10th to 90th $550 to $1,445
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 $676.08 Median $5,495.41 Typical High $10,471.29 | Facility | None | $676.08 | $5,495.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | None | $660.69 | $660.69 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,467.37 Typical High $6,760.83 | Facility | None | $933.25 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $1,659.59 | Professional | None | $446.68 | $724.44 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | None | $691.83 | $1,000.00 | $1,000.00 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,317.64 Typical High $24,547.09 | Facility | None | $4,677.35 | $8,317.64 | $24,547.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,819.70 | Professional | None | $645.65 | $758.58 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,445.44 | Professional | None | $478.63 | $676.08 | $1,445.44 |
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 $331.13 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $489.78 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $501.19 |
Where New Jersey sits
The same service costs 5.4 times more in Oklahoma than in Hawaii. 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 $11,284HI $2,091
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.