How much rates vary
Facilitymedian $6,166 · 10th to 90th $891 to $12,589Professionalmedian $1,585 · 10th to 90th $1,175 to $2,512
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $4,786.30 | Professional | None | $1,122.02 | $1,288.25 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $7,079.46 Typical High $13,182.57 | Facility | None | $2,344.23 | $7,079.46 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,584.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,621.81 | $2,187.76 |
Denver HMP Setting Facility Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,630.27 | Facility | None | $1,288.25 | $1,479.11 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,513.56 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,238.72 | Facility | None | $1,071.52 | $2,137.96 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,071.52 | Professional | None | $741.31 | $741.31 | $1,071.52 |
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 $1,288.25 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,737.80 | $2,754.23 |
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 $616.60 Median $645.65 Typical High $831.76 | Professional | 52 · Reduced service | $616.60 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $331.13 | Professional | 53 · Discontinued | $251.19 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $251.19 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,148.15 |
Where Colorado sits
The same service costs 9.9 times more in Alabama than in Maryland. 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
AL $18,241MD $1,851
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.