How much rates vary
Facilitymedian $2,692 · 10th to 90th $891 to $7,762Professionalmedian $776 · 10th to 90th $398 to $1,202
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 $724.44 Median $6,309.57 Typical High $10,471.29 | Facility | None | $724.44 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | None | $724.44 | $724.44 | $851.14 |
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 $707.95 Median $1,202.26 Typical High $1,548.82 | Professional | None | $707.95 | $1,202.26 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | None | $794.33 | $1,071.52 | $1,071.52 |
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 $776.25 Median $831.76 Typical High $1,202.26 | Professional | None | $776.25 | $831.76 | $1,202.26 |
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 $363.08 Median $478.63 Typical High $1,096.48 | Professional | None | $363.08 | $478.63 | $1,096.48 |
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 $363.08 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $562.34 | Professional | 54 · Surgery only | $549.54 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $524.81 |
Where New Jersey sits
The same service costs 3.0 times more in Alaska 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
AK $5,643MD $1,856
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.