How much rates vary
Facilitymedian $2,754 · 10th to 90th $933 to $7,586Professionalmedian $339 · 10th to 90th $269 to $550
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 $338.84 Median $5,370.32 Typical High $10,471.29 | Facility | None | $338.84 | $5,370.32 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $794.33 | Professional | None | $338.84 | $338.84 | $794.33 |
AmeriHealth Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $467.74 | Professional | None | $331.13 | $331.13 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,778.28 Typical High $2,511.89 | Facility | None | $912.01 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $549.54 | Professional | None | $275.42 | $295.12 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $512.86 | Professional | None | $389.05 | $512.86 | $512.86 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,659.59 | $2,951.21 | $8,912.51 |
Horizon BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $549.54 | Professional | None | $354.81 | $416.87 | $549.54 |
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 $245.47 Median $316.23 Typical High $416.87 | Professional | None | $245.47 | $316.23 | $416.87 |
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 $169.82 Median $169.82 Typical High $190.55 | Professional | 52 · Reduced service | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | 53 · Discontinued | $67.61 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 54 · Surgery only | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $269.15 |
Where New Jersey sits
The same service costs 4.5 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 $4,914MT $1,099
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.