How much rates vary
Facilitymedian $25,119 · 10th to 90th $3,311 to $104,713Professionalmedian $1,288 · 10th to 90th $955 to $2,138
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 $1,318.26 Median $4,168.69 Typical High $93,325.43 | Facility | None | $1,318.26 | $4,168.69 | $93,325.43 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,995.26 | Professional | None | $912.01 | $1,023.29 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,848.93 Median $24,547.09 Typical High $109,647.82 | Facility | None | $15,848.93 | $24,547.09 | $109,647.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,318.26 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $33,884.42 Typical High $46,773.51 | Facility | None | $758.58 | $33,884.42 | $46,773.51 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,380.38 | $1,819.70 |
Denver HMP Setting Facility Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,995.26 | Facility | None | $1,023.29 | $1,258.93 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $44,668.36 | Professional | None | $794.33 | $1,174.90 | $44,668.36 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $40,738.03 | Facility | None | $794.33 | $1,584.89 | $40,738.03 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $794.33 | Professional | None | $549.54 | $549.54 | $794.33 |
United Setting Facility Modifier None Typical Low $11,481.54 Median $38,904.51 Typical High $114,815.36 | Facility | None | $11,481.54 | $38,904.51 | $114,815.36 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,412.54 | $2,290.87 |
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 $489.78 Median $512.86 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $512.86 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $275.42 | Professional | 53 · Discontinued | $194.98 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $776.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $741.31 | $776.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $208.93 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $138.04 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $724.44 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $691.83 | $724.44 | $977.24 |
Where Colorado sits
The same service costs 19.9 times more in Alaska 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
AK $53,750MT $2,699
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.