How much rates vary
Facilitymedian $2,570 · 10th to 90th $525 to $7,079Professionalmedian $309 · 10th to 90th $141 to $776
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 $234.42 Median $3,235.94 Typical High $10,000.00 | Facility | None | $234.42 | $3,235.94 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $512.86 | Professional | None | $234.42 | $426.58 | $512.86 |
AmeriHealth Setting Facility Modifier None Typical Low $1,288.25 Median $2,754.23 Typical High $7,079.46 | Facility | None | $1,288.25 | $2,754.23 | $7,079.46 |
AmeriHealth Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $1,380.38 | Professional | None | $398.11 | $489.78 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,238.72 | Facility | None | $933.25 | $1,513.56 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $467.74 Typical High $776.25 | Professional | None | $269.15 | $467.74 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $776.25 | Professional | None | $549.54 | $758.58 | $776.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $2,818.38 Typical High $7,413.10 | Facility | None | $1,621.81 | $2,818.38 | $7,413.10 |
Horizon BCBS Setting Professional Modifier None Typical Low $208.93 Median $489.78 Typical High $812.83 | Professional | None | $208.93 | $489.78 | $812.83 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,818.38 | $6,760.83 |
United Setting Professional Modifier None Typical Low $102.33 Median $275.42 Typical High $588.84 | Professional | None | $102.33 | $275.42 | $588.84 |
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 $117.49 Median $181.97 Typical High $251.19 | Professional | 52 · Reduced service | $117.49 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $72.44 Typical High $102.33 | Professional | 53 · Discontinued | $46.77 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $275.42 Typical High $380.19 | Professional | 54 · Surgery only | $177.83 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $54.95 Typical High $75.86 | Professional | 55 · Aftercare only | $35.48 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $36.31 Typical High $51.29 | Professional | 56 · Pre-op care only | $23.44 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $257.04 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $165.96 | $257.04 | $354.81 |
Where New Jersey sits
The same service costs 4.6 times more in Colorado 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
CO $4,728MT $1,029
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.