How much rates vary
Facilitymedian $269 · 10th to 90th $182 to $550Professionalmedian $617 · 10th to 90th $275 to $851
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 $257.04 Median $281.84 Typical High $1,230.27 | Facility | None | $257.04 | $281.84 | $1,230.27 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $208.93 | Facility | 54 · Surgery only | $190.55 | $208.93 | $208.93 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $28.18 | Facility | 56 · Pre-op care only | $25.70 | $27.54 | $28.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $524.81 | Professional | None | $223.87 | $275.42 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $229.09 | Professional | 54 · Surgery only | $190.55 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $213.80 |
BCBS Setting Facility Modifier None Typical Low $288.40 Median $302.00 Typical High $676.08 | Facility | None | $288.40 | $302.00 | $676.08 |
BCBS Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $870.96 | Professional | None | $549.54 | $724.44 | $870.96 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $660.69 Median $870.96 Typical High $1,047.13 | Professional | 22 · Increased work | $660.69 | $870.96 | $1,047.13 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $501.19 Typical High $616.60 | Professional | 54 · Surgery only | $389.05 | $501.19 | $616.60 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $72.44 Typical High $87.10 | Professional | 56 · Pre-op care only | $54.95 | $72.44 | $87.10 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $416.87 | $537.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $602.56 | Facility | None | $524.81 | $524.81 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $588.84 Typical High $851.14 | Professional | None | $275.42 | $588.84 | $851.14 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $257.04 Typical High $478.63 | Facility | None | $125.89 | $257.04 | $478.63 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $549.54 Typical High $2,041.74 | Professional | None | $288.40 | $549.54 | $2,041.74 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $575.44 | Professional | None | $269.15 | $478.63 | $575.44 |
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 Facility Modifier 52 · Reduced service Typical Low $128.82 Median $138.04 Typical High $141.25 | Facility | 52 · Reduced service | $128.82 | $138.04 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $56.23 | Facility | 53 · Discontinued | $51.29 | $54.95 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $41.69 | Facility | 55 · Aftercare only | $38.02 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $138.04 Typical High $151.36 | Professional | 52 · Reduced service | $128.82 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $45.71 |
Where North Dakota sits
The same service costs 6.4 times more in Colorado 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
CO $2,602FL $408
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.