How much rates vary
Facilitymedian $3,467 · 10th to 90th $741 to $8,128Professionalmedian $692 · 10th to 90th $617 to $5,370
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 $977.24 Median $4,265.80 Typical High $7,762.47 | Facility | None | $977.24 | $4,265.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $912.01 | Professional | None | $660.69 | $660.69 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $562.34 Typical High $660.69 | Professional | None | $89.13 | $562.34 | $660.69 |
BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $3,981.07 | Facility | None | $630.96 | $1,513.56 | $3,981.07 |
BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,318.26 | Professional | None | $812.83 | $812.83 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $9,772.37 | Facility | None | $758.58 | $5,011.87 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,071.52 | Professional | None | $602.56 | $676.08 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $25,118.86 | Facility | None | $776.25 | $3,801.89 | $25,118.86 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $5,370.32 | Professional | None | $616.60 | $851.14 | $5,370.32 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,168.69 Typical High $8,317.64 | Facility | None | $977.24 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,071.52 | Professional | None | $602.56 | $676.08 | $1,071.52 |
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 $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
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 Arizona sits
The same service costs 6.0 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 $2,323
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.