How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,072 to $9,333Professionalmedian $1,288 · 10th to 90th $692 to $2,570
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 $1,659.59 Median $5,011.87 Typical High $11,481.54 | Facility | None | $1,659.59 | $5,011.87 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,318.26 | Professional | None | $537.03 | $537.03 | $1,318.26 |
BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $9,332.54 Typical High $19,054.61 | Facility | None | $7,079.46 | $9,332.54 | $19,054.61 |
BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,290.87 | $2,454.71 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $2,884.03 | Facility | None | $954.99 | $1,995.26 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,288.25 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $8,912.51 | Facility | None | $1,023.29 | $1,819.70 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $4,365.16 | Professional | None | $691.83 | $1,288.25 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,288.25 | $1,698.24 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $3,019.95 | Facility | None | $954.99 | $2,344.23 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,348.96 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,174.90 | $1,862.09 | $5,495.41 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,548.82 | Professional | None | $691.83 | $1,122.02 | $1,548.82 |
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 $269.15 Median $269.15 Typical High $457.09 | Professional | 52 · Reduced service | $269.15 | $269.15 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $181.97 | Professional | 53 · Discontinued | $107.15 | $107.15 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $676.08 | Professional | 54 · Surgery only | $398.11 | $398.11 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $134.90 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $91.20 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $630.96 |
Where Nebraska sits
The same service costs 3.7 times more in Colorado than in Montana. 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 $6,838MT $1,846
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.