How much rates vary
Facilitymedian $1,479 · 10th to 90th $501 to $5,495Professionalmedian $135 · 10th to 90th $107 to $355
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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | None | $109.65 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $724.44 Typical High $1,659.59 | Facility | None | $407.38 | $724.44 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $524.81 | Professional | None | $117.49 | $173.78 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $169.82 | Professional | None | $117.49 | $165.96 | $169.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,122.02 Typical High $2,630.27 | Facility | None | $616.60 | $1,122.02 | $2,630.27 |
Horizon BCBS Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $363.08 | Professional | None | $112.20 | $120.23 | $363.08 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $501.19 | Professional | None | $95.50 | $128.82 | $501.19 |
5 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 $54.95 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $54.95 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $21.88 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $81.28 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $16.22 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.96 | $13.49 | $13.49 |
Where New Jersey sits
The same service costs 8.1 times more in New York 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
NY $2,852MT $352
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.