How much rates vary
Facilitymedian $6,761 · 10th to 90th $2,692 to $13,183Professionalmedian $2,818 · 10th to 90th $1,905 to $4,571
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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,041.74 | $2,570.40 |
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 $2,290.87 Median $3,311.31 Typical High $4,897.79 | Professional | None | $2,290.87 | $3,311.31 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,677.35 Typical High $7,079.46 | Facility | None | $812.83 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $3,548.13 | Professional | None | $1,659.59 | $2,454.71 | $3,548.13 |
Denver HMP Setting Facility Modifier None Typical Low $1,174.90 Median $2,454.71 Typical High $4,168.69 | Facility | None | $1,174.90 | $2,454.71 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,819.70 | $2,454.71 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $1,819.70 Median $3,890.45 Typical High $6,165.95 | Facility | None | $1,819.70 | $3,890.45 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,819.70 | $2,137.96 | $2,754.23 |
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 $1,148.15 Median $2,570.40 Typical High $4,168.69 | Professional | None | $1,148.15 | $2,570.40 | $4,168.69 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 53 · Discontinued | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $309.03 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,445.44 |
Where Colorado sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.