How much rates vary
Facilitymedian $2,239 · 10th to 90th $219 to $5,129Professionalmedian $389 · 10th to 90th $288 to $631
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 $338.84 Median $3,162.28 Typical High $8,912.51 | Facility | None | $338.84 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $363.08 | Professional | None | $288.40 | $331.13 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $691.83 | Professional | None | $323.59 | $467.74 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $173.78 Typical High $309.03 | Facility | None | $52.48 | $173.78 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $549.54 | Professional | None | $275.42 | $363.08 | $549.54 |
Denver HMP Setting Facility Modifier None Typical Low $288.40 Median $380.19 Typical High $691.83 | Facility | None | $288.40 | $380.19 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $676.08 | Professional | None | $371.54 | $489.78 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $831.76 | Facility | None | $208.93 | $398.11 | $831.76 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $457.09 | Professional | None | $288.40 | $398.11 | $457.09 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $630.96 | Professional | None | $281.84 | $371.54 | $630.96 |
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 $144.54 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $257.04 | Professional | 54 · Surgery only | $218.78 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $51.29 | Professional | 55 · Aftercare only | $43.65 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $223.87 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $204.17 | $223.87 | $239.88 |
Where Colorado sits
The same service costs 6.7 times more in New York than in Florida. 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
NY $2,828FL $419
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.