How much rates vary
Facilitymedian $1,096 · 10th to 90th $135 to $2,042Professionalmedian $437 · 10th to 90th $331 to $813
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 $457.09 Median $588.84 Typical High $4,897.79 | Facility | None | $457.09 | $588.84 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $478.63 | Professional | None | $457.09 | $467.74 | $478.63 |
BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,949.84 | Facility | None | $1,096.48 | $1,122.02 | $1,949.84 |
BCBS Setting Professional Modifier None Typical Low $112.20 Median $562.34 Typical High $851.14 | Professional | None | $112.20 | $562.34 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $812.83 | Professional | None | $269.15 | $380.19 | $812.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $331.13 Median $831.76 Typical High $4,897.79 | Facility | None | $331.13 | $831.76 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $467.74 | Professional | None | $331.13 | $426.58 | $467.74 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $645.65 | Professional | None | $269.15 | $380.19 | $645.65 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,513.56 | Facility | None | $91.20 | $177.83 | $1,513.56 |
United Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $436.52 | Professional | None | $338.84 | $371.54 | $436.52 |
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 $229.09 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $331.13 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 50 · Both sides | $912.01 | $912.01 | $912.01 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $223.87 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $89.13 | $93.33 | $93.33 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $338.84 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $67.61 | $69.18 | $69.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $46.77 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $316.23 | $323.59 | $323.59 |
Where Michigan sits
The same service costs 5.9 times more in Colorado than in Kentucky. 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 $4,303KY $729
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.