How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,259 to $11,482Professionalmedian $617 · 10th to 90th $501 to $1,023
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 $630.96 Median $2,238.72 Typical High $7,762.47 | Facility | None | $630.96 | $2,238.72 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $575.44 | Professional | None | $501.19 | $549.54 | $575.44 |
BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $7,585.78 Typical High $12,022.64 | Facility | None | $5,495.41 | $7,585.78 | $12,022.64 |
BCBS Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Professional | None | $630.96 | $851.14 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $6,606.93 Typical High $8,317.64 | Facility | None | $758.58 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $933.25 | Professional | None | $549.54 | $616.60 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $3,019.95 | Professional | None | $575.44 | $870.96 | $3,019.95 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $758.58 | Professional | None | $630.96 | $691.83 | $758.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $58.88 Typical High $602.56 | Professional | None | $33.11 | $58.88 | $602.56 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,096.48 | Professional | None | $489.78 | $616.60 | $1,096.48 |
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 $251.19 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $380.19 |
Where Illinois sits
The same service costs 7.9 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 $13,624MT $1,722
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.