How much rates vary
Facilitymedian $661 · 10th to 90th $490 to $1,698Professionalmedian $1,072 · 10th to 90th $550 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 $489.78 Median $549.54 Typical High $562.34 | Facility | None | $489.78 | $549.54 | $562.34 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $407.38 | Facility | 54 · Surgery only | $371.54 | $371.54 | $407.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $54.95 | Facility | 56 · Pre-op care only | $48.98 | $50.12 | $54.95 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $380.19 | Facility | 78 · Unplanned return to OR | $346.74 | $346.74 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $676.08 | Professional | None | $457.09 | $501.19 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $371.54 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $389.05 |
BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,479.11 | Professional | None | $954.99 | $1,174.90 | $1,479.11 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $812.83 Typical High $1,023.29 | Professional | 54 · Surgery only | $676.08 | $812.83 | $1,023.29 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $117.49 Typical High $147.91 | Professional | 56 · Pre-op care only | $95.50 | $117.49 | $147.91 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $870.96 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $724.44 | $870.96 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Facility | None | $954.99 | $954.99 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $1,548.82 | Professional | None | $562.34 | $1,071.52 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $776.25 Typical High $1,621.81 | Facility | None | $489.78 | $776.25 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $3,715.35 | Professional | None | $562.34 | $1,047.13 | $3,715.35 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $512.86 Median $933.25 Typical High $1,096.48 | Professional | None | $512.86 | $933.25 | $1,096.48 |
8 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 Facility Modifier 52 · Reduced service Typical Low $245.47 Median $251.19 Typical High $269.15 | Facility | 52 · Reduced service | $245.47 | $251.19 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $109.65 | Facility | 53 · Discontinued | $97.72 | $100.00 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $81.28 | Facility | 55 · Aftercare only | $74.13 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $83.18 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $1,148.15 Median $1,412.54 Typical High $1,778.28 | Professional | 22 · Increased work | $1,148.15 | $1,412.54 | $1,778.28 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,737.80 Typical High $2,187.76 | Professional | 50 · Both sides | $1,445.44 | $1,737.80 | $2,187.76 |
Where North Dakota sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.