How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,148 to $7,943Professionalmedian $1,000 · 10th to 90th $832 to $2,692
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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | None | $851.14 | $851.14 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,698.24 Typical High $2,691.53 | Facility | None | $831.76 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $3,090.30 | Professional | None | $870.96 | $1,445.44 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,445.44 | $1,479.11 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $7,943.28 | Facility | None | $1,584.89 | $2,818.38 | $7,943.28 |
Horizon BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $2,884.03 | Professional | None | $912.01 | $1,000.00 | $2,884.03 |
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 $776.25 Median $1,023.29 Typical High $4,265.80 | Professional | None | $776.25 | $1,023.29 | $4,265.80 |
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 $426.58 Median $426.58 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $691.83 |
Where New Jersey sits
The same service costs 3.7 times more in Alabama than in Maryland. 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
AL $7,687MD $2,103
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.