How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,445 to $12,589Professionalmedian $676 · 10th to 90th $490 to $1,096
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 $4,168.69 Typical High $11,748.98 | Facility | None | $758.58 | $4,168.69 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $851.14 | Professional | None | $478.63 | $489.78 | $851.14 |
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 $562.34 Median $794.33 Typical High $1,174.90 | Professional | None | $562.34 | $794.33 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,318.26 | $2,454.71 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $831.76 | Professional | None | $478.63 | $588.84 | $831.76 |
Denver HMP Setting Facility Modifier None Typical Low $446.68 Median $630.96 Typical High $1,047.13 | Facility | None | $446.68 | $630.96 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $933.25 | Professional | None | $467.74 | $616.60 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $933.25 Typical High $2,754.23 | Facility | None | $467.74 | $933.25 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $707.95 | Professional | None | $467.74 | $512.86 | $707.95 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $977.24 | Professional | None | $467.74 | $616.60 | $977.24 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $363.08 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $338.84 | $346.74 | $346.74 |
Where Colorado sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.