How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,660 to $10,233Professionalmedian $1,318 · 10th to 90th $1,096 to $1,995
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 $4,466.84 Median $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,318.26 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $4,168.69 | Facility | None | $1,819.70 | $2,818.38 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,258.93 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,584.89 | $2,089.30 | $2,089.30 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,570.88 Typical High $15,848.93 | Facility | None | $2,511.89 | $4,570.88 | $15,848.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,659.59 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,258.93 | $1,659.59 |
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 $660.69 Median $660.69 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,122.02 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Delaware. 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 $10,952DE $3,164
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.