How much rates vary
Facilitymedian $1,380 · 10th to 90th $331 to $7,079Professionalmedian $151 · 10th to 90th $74 to $282
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 $114.82 Median $3,311.31 Typical High $10,000.00 | Facility | None | $114.82 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $208.93 | Professional | None | $112.20 | $169.82 | $208.93 |
AmeriHealth Setting Facility Modifier None Typical Low $831.76 Median $8,317.64 Typical High $16,218.10 | Facility | None | $831.76 | $8,317.64 | $16,218.10 |
AmeriHealth Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $323.59 | Professional | None | $97.72 | $97.72 | $323.59 |
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 $141.25 Median $186.21 Typical High $281.84 | Professional | None | $141.25 | $186.21 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $275.42 | Professional | None | $204.17 | $275.42 | $275.42 |
Horizon BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,122.02 Typical High $2,630.27 | Facility | None | $588.84 | $1,122.02 | $2,630.27 |
Horizon BCBS Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $338.84 | Professional | None | $117.49 | $199.53 | $338.84 |
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 $60.26 Median $102.33 Typical High $234.42 | Professional | None | $60.26 | $102.33 | $234.42 |
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 $56.23 Median $72.44 Typical High $89.13 | Professional | 52 · Reduced service | $56.23 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $29.51 Typical High $35.48 | Professional | 53 · Discontinued | $22.39 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $109.65 Typical High $134.90 | Professional | 54 · Surgery only | $85.11 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.88 Typical High $26.92 | Professional | 55 · Aftercare only | $16.98 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.79 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.22 | $14.79 | $17.78 |
Where New Jersey sits
The same service costs 6.3 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 $2,712MT $427
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.