How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,413 to $8,913Professionalmedian $646 · 10th to 90th $479 to $1,047
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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $3,630.78 | Professional | None | $436.52 | $501.19 | $3,630.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,047.13 | Professional | None | $501.19 | $707.95 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $2,818.38 | Facility | None | $588.84 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $831.76 | Professional | None | $467.74 | $630.96 | $831.76 |
Denver HMP Setting Facility Modifier None Typical Low $501.19 Median $575.44 Typical High $1,023.29 | Facility | None | $501.19 | $575.44 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $851.14 | Professional | None | $407.38 | $575.44 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $2,454.71 | Facility | None | $407.38 | $812.83 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $794.33 | Professional | None | $281.84 | $407.38 | $794.33 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,000.00 | Professional | None | $489.78 | $616.60 | $1,000.00 |
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 $239.88 Median $251.19 Typical High $257.04 | Professional | 52 · Reduced service | $239.88 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | 53 · Discontinued | $95.50 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $51.29 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $363.08 |
Where Colorado sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.