How much rates vary
Facilitymedian $6,761 · 10th to 90th $2,570 to $13,183Professionalmedian $2,291 · 10th to 90th $1,660 to $3,631
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 $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 $1,659.59 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,659.59 | $2,344.23 |
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 $1,905.46 Median $2,691.53 Typical High $3,981.07 | Professional | None | $1,905.46 | $2,691.53 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,888.44 Typical High $9,332.54 | Facility | None | $812.83 | $5,888.44 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,698.24 | $2,089.30 | $2,951.21 |
Denver HMP Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $3,388.44 | Facility | None | $1,659.59 | $2,089.30 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,995.26 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $3,162.28 Typical High $8,128.31 | Facility | None | $1,479.11 | $3,162.28 | $8,128.31 |
Select Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,698.24 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,187.76 | $3,467.37 |
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 $812.83 Median $812.83 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,174.90 |
Where Colorado sits
The same service costs 4.7 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 $16,761KY $3,604
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.