How much rates vary
Facilitymedian $6,761 · 10th to 90th $2,089 to $13,183Professionalmedian $813 · 10th to 90th $589 to $1,318
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 $758.58 Median $3,235.94 Typical High $10,715.19 | Facility | None | $758.58 | $3,235.94 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $1,023.29 | Professional | None | $575.44 | $588.84 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,412.54 | Professional | None | $660.69 | $954.99 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,344.23 Typical High $3,311.31 | Facility | None | $831.76 | $2,344.23 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,023.29 | Professional | None | $549.54 | $724.44 | $1,023.29 |
Denver HMP Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $1,258.93 | Facility | None | $537.03 | $707.95 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,122.02 | Professional | None | $562.34 | $741.31 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $1,122.02 Typical High $2,754.23 | Facility | None | $562.34 | $1,122.02 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $831.76 | Professional | None | $562.34 | $616.60 | $831.76 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,174.90 | Professional | None | $549.54 | $724.44 | $1,174.90 |
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 $295.12 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $416.87 |
Where Colorado sits
The same service costs 4.7 times more in Oklahoma 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
OK $8,820MT $1,888
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.