How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,660 to $12,589Professionalmedian $891 · 10th to 90th $661 to $1,445
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 $831.76 Median $3,235.94 Typical High $10,715.19 | Facility | None | $831.76 | $3,235.94 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,122.02 | Professional | None | $645.65 | $660.69 | $1,122.02 |
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 $741.31 Median $1,071.52 Typical High $1,584.89 | Professional | None | $741.31 | $1,071.52 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $5,370.32 Typical High $10,471.29 | Facility | None | $831.76 | $5,370.32 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,122.02 | Professional | None | $660.69 | $794.33 | $1,122.02 |
Denver HMP Setting Facility Modifier None Typical Low $660.69 Median $870.96 Typical High $1,380.38 | Facility | None | $660.69 | $870.96 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,230.27 | Professional | None | $616.60 | $831.76 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $9,120.11 | Facility | None | $616.60 | $1,230.27 | $9,120.11 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $933.25 | Professional | None | $616.60 | $676.08 | $933.25 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,318.26 | Professional | None | $645.65 | $831.76 | $1,318.26 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
Where Colorado sits
The same service costs 5.4 times more in Alaska 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
AK $11,142MT $2,070
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.