How much rates vary
Facilitymedian $2,291 · 10th to 90th $269 to $5,248Professionalmedian $631 · 10th to 90th $479 to $1,023
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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $724.44 | Professional | None | $478.63 | $512.86 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,148.15 | Professional | None | $537.03 | $776.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $302.00 Typical High $1,659.59 | Facility | None | $173.78 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $870.96 | Professional | None | $457.09 | $575.44 | $870.96 |
Denver HMP Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $1,047.13 | Facility | None | $478.63 | $602.56 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $977.24 | Professional | None | $537.03 | $724.44 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $562.34 Typical High $1,174.90 | Facility | None | $208.93 | $562.34 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $691.83 | Professional | None | $467.74 | $562.34 | $691.83 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $1,000.00 | Professional | None | $457.09 | $602.56 | $1,000.00 |
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 $239.88 Median $251.19 Typical High $257.04 | Professional | 52 · Reduced service | $239.88 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | 53 · Discontinued | $95.50 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $389.05 | Professional | 54 · Surgery only | $354.81 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $51.29 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $363.08 |
Where Colorado sits
The same service costs 4.7 times more in New York than in Florida. 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
NY $3,038FL $649
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.