How much rates vary
Facilitymedian $18,621 · 10th to 90th $1,096 to $40,738Professionalmedian $6,918 · 10th to 90th $4,786 to $10,715
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 $3,090.30 Median $5,495.41 Typical High $8,912.51 | Facility | None | $3,090.30 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $5,495.41 Typical High $5,888.44 | Professional | None | $3,981.07 | $5,495.41 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,848.93 Median $20,892.96 Typical High $50,118.72 | Facility | None | $15,848.93 | $20,892.96 | $50,118.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,370.32 Median $7,585.78 Typical High $11,220.18 | Professional | None | $5,370.32 | $7,585.78 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
Denver HMP Setting Facility Modifier None Typical Low $4,168.69 Median $5,495.41 Typical High $10,964.78 | Facility | None | $4,168.69 | $5,495.41 | $10,964.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,466.84 Median $6,165.95 Typical High $9,332.54 | Professional | None | $4,466.84 | $6,165.95 | $9,332.54 |
Select Health Setting Facility Modifier None Typical Low $4,466.84 Median $8,912.51 Typical High $9,332.54 | Facility | None | $4,466.84 | $8,912.51 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,466.84 Typical High $8,709.64 | Professional | None | $3,090.30 | $4,466.84 | $8,709.64 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $4,073.80 Median $6,760.83 Typical High $11,220.18 | Professional | None | $4,073.80 | $6,760.83 | $11,220.18 |
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 $2,630.27 Median $2,754.23 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,630.27 | $2,754.23 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,096.48 Typical High $1,148.15 | Professional | 53 · Discontinued | $1,047.13 | $1,096.48 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,890.45 Median $4,168.69 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,890.45 | $4,168.69 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $831.76 Typical High $851.14 | Professional | 55 · Aftercare only | $776.25 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $549.54 Typical High $575.44 | Professional | 56 · Pre-op care only | $524.81 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,630.78 Median $3,890.45 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $3,630.78 | $3,890.45 | $3,981.07 |
Where Colorado sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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
WI $28,671TX $3,407
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.