How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,148 to $32,359Professionalmedian $1,380 · 10th to 90th $871 to $2,630
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 $1,148.15 Median $1,148.15 Typical High $1,412.54 | Facility | None | $1,148.15 | $1,148.15 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,047.13 | $1,584.89 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,047.13 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $10,000.00 | Facility | None | $1,698.24 | $2,511.89 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,047.13 | $1,621.81 | $2,951.21 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $16,218.10 Typical High $36,307.81 | Facility | None | $4,466.84 | $16,218.10 | $36,307.81 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,584.89 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $4,073.80 Typical High $20,417.38 | Facility | None | $1,905.46 | $4,073.80 | $20,417.38 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $2,630.27 | Professional | None | $812.83 | $1,202.26 | $2,630.27 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
Where West Virginia 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.