How much rates vary
Facilitymedian $6,310 · 10th to 90th $2,138 to $12,589Professionalmedian $1,862 · 10th to 90th $1,380 to $2,884
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 $1,348.96 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,479.11 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,905.46 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,981.07 Typical High $6,025.60 | Facility | None | $758.58 | $3,981.07 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,949.84 | $2,630.27 |
Denver HMP Setting Facility Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,951.21 | Facility | None | $1,348.96 | $1,778.28 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,659.59 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,511.89 Typical High $5,248.07 | Facility | None | $1,202.26 | $2,511.89 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,202.26 | Professional | None | $831.76 | $831.76 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,479.11 | $2,041.74 | $3,311.31 |
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 $724.44 Median $741.31 Typical High $1,000.00 | Professional | 52 · Reduced service | $724.44 | $741.31 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $398.11 | Professional | 53 · Discontinued | $288.40 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $302.00 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $199.53 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,412.54 |
Where Colorado sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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 $18,462KY $2,797
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.