How much rates vary
Facilitymedian $1,288 · 10th to 90th $525 to $2,754Professionalmedian $417 · 10th to 90th $316 to $724
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 $416.87 Median $2,884.03 Typical High $4,897.79 | Facility | None | $416.87 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $426.58 | Professional | None | $363.08 | $426.58 | $426.58 |
BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $2,238.72 | Facility | None | $1,288.25 | $1,318.26 | $2,238.72 |
BCBS Setting Professional Modifier None Typical Low $97.72 Median $512.86 Typical High $724.44 | Professional | None | $97.72 | $512.86 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $812.83 | Professional | None | $245.47 | $380.19 | $812.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $776.25 Median $977.24 Typical High $4,897.79 | Facility | None | $776.25 | $977.24 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $446.68 | Professional | None | $316.23 | $407.38 | $446.68 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $575.44 | Professional | None | $245.47 | $380.19 | $575.44 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $416.87 | Professional | None | $331.13 | $354.81 | $416.87 |
13 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 $208.93 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $208.93 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $41.69 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $302.00 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 50 · Both sides | $776.25 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $208.93 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $83.18 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $41.69 | $42.66 | $42.66 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $302.00 |
Where Michigan sits
The same service costs 4.6 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 $4,822MT $1,050
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.