How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $7,413Professionalmedian $1,514 · 10th to 90th $1,096 to $2,399
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 $1,445.44 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,445.44 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,445.44 | $1,513.56 | $1,513.56 |
BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,265.80 | $7,413.10 |
BCBS Setting Professional Modifier None Typical Low $371.54 Median $1,621.81 Typical High $2,398.83 | Professional | None | $371.54 | $1,621.81 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $2,754.23 | Professional | None | $870.96 | $1,348.96 | $2,754.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,951.21 Median $5,011.87 Typical High $6,918.31 | Facility | None | $2,951.21 | $5,011.87 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,479.11 | $1,659.59 |
Priority Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Priority Health Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,995.26 | Professional | None | $870.96 | $1,348.96 | $1,995.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,912.51 | Facility | None | $851.14 | $2,238.72 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,380.38 | $1,548.82 |
12 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 $724.44 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,071.52 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $295.12 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,148.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,071.52 | $1,071.52 |
Where Michigan sits
The same service costs 4.0 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 $14,467MT $3,639
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.