How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,202 to $11,482Professionalmedian $661 · 10th to 90th $479 to $1,000
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 $630.96 Median $7,244.36 Typical High $12,882.50 | Facility | None | $630.96 | $7,244.36 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,258.93 | Professional | None | $630.96 | $758.58 | $1,258.93 |
AmeriHealth Setting Facility Modifier None Typical Low $2,951.21 Median $5,370.32 Typical High $7,413.10 | Facility | None | $2,951.21 | $5,370.32 | $7,413.10 |
AmeriHealth Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $891.25 | Professional | None | $602.56 | $602.56 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $5,370.32 Typical High $9,120.11 | Facility | None | $1,995.26 | $5,370.32 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $1,047.13 | Professional | None | $512.86 | $549.54 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $933.25 | Professional | None | $707.95 | $933.25 | $933.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $5,248.07 Typical High $19,952.62 | Facility | None | $2,884.03 | $5,248.07 | $19,952.62 |
Horizon BCBS Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,000.00 | Professional | None | $660.69 | $758.58 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $831.76 | Professional | None | $446.68 | $575.44 | $831.76 |
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 $316.23 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $75.86 |
Where New Jersey sits
The same service costs 5.9 times more in Alaska 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
AK $12,304MT $2,095
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.