How much rates vary
Facilitymedian $6,761 · 10th to 90th $2,291 to $13,183Professionalmedian $1,175 · 10th to 90th $813 to $1,862
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | None | $812.83 | $812.83 | $912.01 |
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 $977.24 Median $1,380.38 Typical High $2,041.74 | Professional | None | $977.24 | $1,380.38 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,398.83 Typical High $3,090.30 | Facility | None | $812.83 | $2,398.83 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,513.56 | Professional | None | $912.01 | $1,096.48 | $1,513.56 |
Denver HMP Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,698.24 | Facility | None | $812.83 | $1,122.02 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,513.56 | Professional | None | $758.58 | $1,000.00 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $1,584.89 Typical High $2,754.23 | Facility | None | $758.58 | $1,584.89 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,122.02 | Professional | None | $758.58 | $851.14 | $1,122.02 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,819.70 | Professional | None | $891.25 | $1,148.15 | $1,819.70 |
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 $407.38 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $162.18 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $616.60 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $602.56 |
Where Colorado sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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 $11,256KY $2,261
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.