How much rates vary
Facilitymedian $10,000 · 10th to 90th $933 to $17,783Professionalmedian $1,230 · 10th to 90th $851 to $1,950
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 $831.76 Median $831.76 Typical High $1,698.24 | Professional | None | $831.76 | $831.76 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,413.10 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $2,041.74 | Professional | None | $977.24 | $1,380.38 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,659.59 | Professional | None | $912.01 | $1,230.27 | $1,659.59 |
Denver HMP Setting Facility Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,230.27 | Facility | None | $812.83 | $1,071.52 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,698.24 | Professional | None | $812.83 | $1,148.15 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $1,621.81 Typical High $1,698.24 | Facility | None | $812.83 | $1,621.81 | $1,698.24 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,584.89 | Professional | None | $562.34 | $812.83 | $1,584.89 |
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 $933.25 Median $1,202.26 Typical High $1,949.84 | Professional | None | $933.25 | $1,202.26 | $1,949.84 |
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 $416.87 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | 53 · Discontinued | $165.96 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | 54 · Surgery only | $616.60 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $616.60 |
Where Colorado sits
The same service costs 18.1 times more in Maine than in Arkansas. 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
ME $27,451AR $1,513
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.