How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,202 to $11,749Professionalmedian $1,000 · 10th to 90th $631 to $2,138
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 $977.24 Median $6,918.31 Typical High $13,803.84 | Facility | None | $977.24 | $6,918.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,949.84 | Professional | None | $977.24 | $977.24 | $1,949.84 |
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 $707.95 Median $1,071.52 Typical High $2,398.83 | Professional | None | $707.95 | $1,071.52 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $1,445.44 | Professional | None | $977.24 | $1,445.44 | $1,445.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $22,387.21 | Facility | None | $4,677.35 | $8,511.38 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,884.03 | Professional | None | $977.24 | $1,174.90 | $2,884.03 |
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 $512.86 Median $758.58 Typical High $2,137.96 | Professional | None | $512.86 | $758.58 | $2,137.96 |
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 $478.63 Median $478.63 Typical High $524.81 | Professional | 52 · Reduced service | $478.63 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $194.98 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $724.44 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $741.31 |
Where New Jersey sits
The same service costs 3.6 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 $11,248MT $3,134
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.