How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,585 to $9,550Professionalmedian $1,072 · 10th to 90th $912 to $1,905
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 $1,000.00 Median $2,344.23 Typical High $9,549.93 | Facility | None | $1,000.00 | $2,344.23 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $2,137.96 | Professional | None | $954.99 | $1,071.52 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $7,244.36 | Facility | None | $1,096.48 | $4,073.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,905.46 | Professional | None | $954.99 | $1,023.29 | $1,905.46 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $6,309.57 Typical High $35,481.34 | Facility | None | $3,890.45 | $6,309.57 | $35,481.34 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,348.96 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $5,011.87 | Facility | None | $1,584.89 | $2,818.38 | $5,011.87 |
United Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,479.11 | Professional | None | $851.14 | $954.99 | $1,479.11 |
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 $512.86 Median $537.03 Typical High $549.54 | Professional | 52 · Reduced service | $512.86 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $776.25 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $112.20 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $776.25 |
Where Delaware sits
The same service costs 4.2 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 $14,362MT $3,396
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.