How much rates vary
Facilitymedian $427 · 10th to 90th $339 to $1,698Professionalmedian $776 · 10th to 90th $398 to $1,122
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 $426.58 Typical High $426.58 | Facility | None | $338.84 | $426.58 | $426.58 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $251.19 Median $263.03 Typical High $323.59 | Facility | 54 · Surgery only | $251.19 | $263.03 | $323.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $42.66 | Facility | 56 · Pre-op care only | $33.88 | $34.67 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $245.47 Typical High $302.00 | Facility | 78 · Unplanned return to OR | $234.42 | $245.47 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $562.34 | Professional | None | $309.03 | $398.11 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $302.00 Typical High $331.13 | Professional | 54 · Surgery only | $251.19 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $281.84 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $234.42 | $281.84 | $309.03 |
BCBS Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,122.02 | Professional | None | $660.69 | $851.14 | $1,122.02 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $794.33 Median $1,023.29 Typical High $1,348.96 | Professional | 22 · Increased work | $794.33 | $1,023.29 | $1,348.96 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $588.84 Typical High $794.33 | Professional | 54 · Surgery only | $457.09 | $588.84 | $794.33 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $112.20 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $112.20 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $630.96 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $489.78 | $630.96 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $870.96 | Facility | None | $758.58 | $758.58 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $812.83 Typical High $1,174.90 | Professional | None | $426.58 | $812.83 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $676.08 Typical High $1,698.24 | Facility | None | $338.84 | $676.08 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $812.83 Typical High $2,570.40 | Professional | None | $446.68 | $812.83 | $2,570.40 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $354.81 Median $645.65 Typical High $851.14 | Professional | None | $354.81 | $645.65 | $851.14 |
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 Facility Modifier 52 · Reduced service Typical Low $169.82 Median $173.78 Typical High $213.80 | Facility | 52 · Reduced service | $169.82 | $173.78 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $67.61 Median $69.18 Typical High $85.11 | Facility | 53 · Discontinued | $67.61 | $69.18 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $50.12 Median $52.48 Typical High $64.57 | Facility | 55 · Aftercare only | $50.12 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $66.07 |
Where North Dakota sits
The same service costs 3.8 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 $4,471MT $1,166
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.