How much rates vary
Facilitymedian $3,467 · 10th to 90th $550 to $6,457Professionalmedian $562 · 10th to 90th $347 to $871
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 $691.83 Typical High $4,073.80 | Facility | None | $489.78 | $691.83 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $707.95 | Professional | None | $316.23 | $501.19 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $6,025.60 | Facility | None | $3,467.37 | $3,548.13 | $6,025.60 |
BCBS Setting Professional Modifier None Typical Low $114.82 Median $812.83 Typical High $977.24 | Professional | None | $114.82 | $812.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $1,023.29 | Professional | None | $309.03 | $537.03 | $1,023.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $501.19 Median $1,445.44 Typical High $7,079.46 | Facility | None | $501.19 | $1,445.44 | $7,079.46 |
Health Alliance Plan Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $741.31 | Professional | None | $380.19 | $549.54 | $741.31 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $794.33 | Professional | None | $288.40 | $489.78 | $794.33 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $707.95 | Professional | None | $416.87 | $549.54 | $707.95 |
13 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 $245.47 Median $257.04 Typical High $354.81 | Professional | 52 · Reduced service | $245.47 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $144.54 | Professional | 53 · Discontinued | $97.72 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $537.03 | Professional | 54 · Surgery only | $371.54 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $107.15 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $70.79 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $501.19 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $912.01 Typical High $1,479.11 | Professional | 50 · Both sides | $912.01 | $912.01 | $1,479.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $251.19 Typical High $371.54 | Professional | 52 · Reduced service | $245.47 | $251.19 | $371.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $97.72 | $102.33 | $147.91 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $549.54 | Professional | 54 · Surgery only | $363.08 | $380.19 | $549.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $109.65 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $109.65 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $74.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $512.86 |
Where Michigan 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 $6,199MT $1,425
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.