How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,905 to $11,749Professionalmedian $1,349 · 10th to 90th $871 to $2,884
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 $9,332.54 Typical High $14,125.38 | Facility | None | $4,466.84 | $9,332.54 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,288.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $4,265.80 Typical High $6,760.83 | Facility | None | $1,548.82 | $4,265.80 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $3,388.44 | Professional | None | $1,023.29 | $1,445.44 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,380.38 | $2,089.30 | $2,089.30 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,511.38 Typical High $22,387.21 | Facility | None | $4,786.30 | $8,511.38 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $3,801.89 | Professional | None | $1,318.26 | $1,584.89 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $2,884.03 | Professional | None | $724.44 | $1,096.48 | $2,884.03 |
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 $630.96 Median $630.96 Typical High $707.95 | Professional | 52 · Reduced service | $630.96 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 53 · Discontinued | $257.04 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,000.00 |
Where New Jersey sits
The same service costs 3.0 times more in Alaska than in Vermont. 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 $12,999VT $4,294
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.