How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,288 to $21,380Professionalmedian $661 · 10th to 90th $479 to $1,072
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 $616.60 Median $3,388.44 Typical High $9,120.11 | Facility | None | $616.60 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $724.44 | Professional | None | $478.63 | $478.63 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $15,135.61 Typical High $25,703.96 | Facility | None | $10,000.00 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,148.15 | Professional | None | $549.54 | $776.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,630.78 Typical High $7,079.46 | Facility | None | $588.84 | $3,630.78 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $851.14 | Professional | None | $501.19 | $602.56 | $851.14 |
Denver HMP Setting Facility Modifier None Typical Low $478.63 Median $630.96 Typical High $1,047.13 | Facility | None | $478.63 | $630.96 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $912.01 | Professional | None | $457.09 | $602.56 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $6,165.95 | Facility | None | $457.09 | $912.01 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $676.08 | Professional | None | $457.09 | $501.19 | $676.08 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,000.00 | Professional | None | $489.78 | $616.60 | $1,000.00 |
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 $239.88 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $338.84 |
Where Colorado sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.