How much rates vary
Facilitymedian $1,549 · 10th to 90th $479 to $3,802Professionalmedian $550 · 10th to 90th $447 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 $549.54 Median $1,288.25 Typical High $2,454.71 | Facility | None | $549.54 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | None | $467.74 | $549.54 | $549.54 |
BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $3,019.95 Typical High $4,168.69 | Facility | None | $1,513.56 | $3,019.95 | $4,168.69 |
BCBS Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $724.44 | Professional | None | $537.03 | $602.56 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,412.54 Typical High $1,862.09 | Facility | None | $512.86 | $1,412.54 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $794.33 | Professional | None | $380.19 | $724.44 | $794.33 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,511.89 | Facility | None | $407.38 | $588.84 | $2,511.89 |
United Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $954.99 | Professional | None | $398.11 | $501.19 | $954.99 |
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 $234.42 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $46.77 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $323.59 | $380.19 | $380.19 |
Where Arkansas sits
The same service costs 5.4 times more in Colorado than in Alabama. 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 $6,331AL $1,183
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.