How much rates vary
Facilitymedian $1,622 · 10th to 90th $794 to $4,169Professionalmedian $617 · 10th to 90th $417 to $832
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 $512.86 Median $1,230.27 Typical High $2,041.74 | Facility | None | $512.86 | $1,230.27 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $707.95 | Professional | None | $436.52 | $512.86 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $645.65 | Professional | None | $302.00 | $302.00 | $645.65 |
BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $3,019.95 Typical High $4,168.69 | Facility | None | $1,513.56 | $3,019.95 | $4,168.69 |
BCBS Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $831.76 | Professional | None | $457.09 | $616.60 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,412.54 Typical High $1,862.09 | Facility | None | $562.34 | $1,412.54 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $954.99 | Professional | None | $426.58 | $707.95 | $954.99 |
Qualchoice Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $741.31 | Professional | None | $346.74 | $346.74 | $741.31 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $3,388.44 | Facility | None | $794.33 | $1,122.02 | $3,388.44 |
United Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $933.25 | Professional | None | $398.11 | $575.44 | $933.25 |
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 $257.04 Median $263.03 Typical High $354.81 | Professional | 52 · Reduced service | $257.04 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $141.25 | Professional | 53 · Discontinued | $102.33 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $537.03 | Professional | 54 · Surgery only | $389.05 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $70.79 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $501.19 |
Where Arkansas sits
The same service costs 4.3 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 $6,505MT $1,508
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.