How much rates vary
Facilitymedian $2,291 · 10th to 90th $145 to $5,248Professionalmedian $135 · 10th to 90th $95 to $224
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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $158.49 | Professional | None | $95.50 | $120.23 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $229.09 | Professional | None | $107.15 | $154.88 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $125.89 Typical High $229.09 | Facility | None | $52.48 | $125.89 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $204.17 | Professional | None | $91.20 | $128.82 | $204.17 |
Denver HMP Setting Facility Modifier None Typical Low $95.50 Median $138.04 Typical High $229.09 | Facility | None | $95.50 | $138.04 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $263.03 | Professional | None | $123.03 | $173.78 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $165.96 Typical High $323.59 | Facility | None | $154.88 | $165.96 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $154.88 | Professional | None | $95.50 | $134.90 | $154.88 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $234.42 | Professional | None | $95.50 | $128.82 | $234.42 |
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 $47.86 Median $58.88 Typical High $64.57 | Professional | 52 · Reduced service | $47.86 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $23.44 Typical High $26.30 | Professional | 53 · Discontinued | $19.05 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $89.13 Typical High $97.72 | Professional | 54 · Surgery only | $72.44 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.78 Typical High $19.50 | Professional | 55 · Aftercare only | $14.45 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $83.18 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $67.61 | $83.18 | $91.20 |
Where Colorado sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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
HI $2,944MD $224
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.