How much rates vary
Facilitymedian $3,802 · 10th to 90th $447 to $8,318Professionalmedian $575 · 10th to 90th $437 to $955
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 $446.68 Median $478.63 Typical High $489.78 | Professional | None | $446.68 | $478.63 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,071.52 | Professional | None | $489.78 | $707.95 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,230.27 Typical High $1,659.59 | Facility | None | $436.52 | $1,230.27 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $831.76 | Professional | None | $398.11 | $537.03 | $831.76 |
Denver HMP Setting Facility Modifier None Typical Low $446.68 Median $562.34 Typical High $977.24 | Facility | None | $446.68 | $562.34 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $912.01 | Professional | None | $512.86 | $676.08 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,445.44 | Facility | None | $537.03 | $1,000.00 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $645.65 | Professional | None | $436.52 | $537.03 | $645.65 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,995.26 | Facility | None | $239.88 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $912.01 | Professional | None | $407.38 | $549.54 | $912.01 |
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 $223.87 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $223.87 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $89.13 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $371.54 | Professional | 54 · Surgery only | $331.13 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $346.74 |
Where Colorado sits
The same service costs 5.3 times more in Colorado 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
CO $4,377FL $831
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.