How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,230 to $9,333Professionalmedian $891 · 10th to 90th $631 to $7,586
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 $1,258.93 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,258.93 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,174.90 | Professional | None | $630.96 | $794.33 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $1,819.70 Typical High $1,819.70 | Professional | None | $398.11 | $1,819.70 | $1,819.70 |
BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,317.64 | Facility | None | $1,318.26 | $3,467.37 | $8,317.64 |
BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,698.24 | Professional | None | $724.44 | $1,071.52 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,011.87 Typical High $10,471.29 | Facility | None | $602.56 | $5,011.87 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,202.26 | Professional | None | $660.69 | $851.14 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $10,232.93 | Facility | None | $1,778.28 | $6,025.60 | $10,232.93 |
United Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,479.11 | Professional | None | $588.84 | $794.33 | $1,479.11 |
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 $316.23 Median $331.13 Typical High $457.09 | Professional | 52 · Reduced service | $316.23 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $181.97 | Professional | 53 · Discontinued | $125.89 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $691.83 | Professional | 54 · Surgery only | $467.74 | $501.19 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $91.20 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $645.65 |
Where Tennessee sits
The same service costs 6.1 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 $13,882MT $2,270
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.