How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,479 to $28,840Professionalmedian $302 · 10th to 90th $186 to $525
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 $302.00 Median $302.00 Typical High $323.59 | Professional | None | $302.00 | $302.00 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $17,782.79 Typical High $30,199.52 | Facility | None | $691.83 | $17,782.79 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $660.69 | Professional | None | $309.03 | $524.81 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $501.19 | Professional | None | $380.19 | $501.19 | $501.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $13,803.84 Typical High $79,432.82 | Facility | None | $7,762.47 | $13,803.84 | $79,432.82 |
Horizon BCBS Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $537.03 | Professional | None | $295.12 | $354.81 | $537.03 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,623.41 Typical High $15,488.17 | Facility | None | $1,659.59 | $5,623.41 | $15,488.17 |
United Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $501.19 | Professional | None | $173.78 | $223.87 | $501.19 |
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 $151.36 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $151.36 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $60.26 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | 54 · Surgery only | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $223.87 |
Where New Jersey sits
The same service costs 29.1 times more in Alabama 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
AL $30,626MT $1,051
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.