How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,023 to $10,965Professionalmedian $1,820 · 10th to 90th $1,349 to $2,951
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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
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 $1,479.11 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,479.11 | $2,137.96 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,691.53 | Facility | None | $691.83 | $1,778.28 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,621.81 | $2,398.83 |
Denver HMP Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,951.21 | Facility | None | $1,288.25 | $1,659.59 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,737.80 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $2,691.53 | Facility | None | $1,288.25 | $2,089.30 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,479.11 | $1,949.84 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,659.59 | $2,818.38 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Where Colorado sits
The same service costs 3.7 times more in Alaska than in Delaware. 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
AK $8,917DE $2,410
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.