How much rates vary
Facilitymedian $10,471 · 10th to 90th $3,236 to $17,783Professionalmedian $3,981 · 10th to 90th $525 to $12,023
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 $5,888.44 Typical High $17,782.79 | Facility | None | $3,090.30 | $5,888.44 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $5,128.61 Typical High $6,456.54 | Professional | None | $446.68 | $5,128.61 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $5,623.41 Typical High $12,302.69 | Professional | None | $537.03 | $5,623.41 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $8,128.31 Typical High $14,454.40 | Facility | None | $891.25 | $8,128.31 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,202.26 Typical High $10,715.19 | Professional | None | $562.34 | $1,202.26 | $10,715.19 |
Denver HMP Setting Facility Modifier None Typical Low $446.68 Median $1,380.38 Typical High $10,471.29 | Facility | None | $446.68 | $1,380.38 | $10,471.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $2,344.23 Typical High $10,471.29 | Professional | None | $501.19 | $2,344.23 | $10,471.29 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $11,481.54 Typical High $12,882.50 | Facility | None | $812.83 | $11,481.54 | $12,882.50 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $6,165.95 | Professional | None | $371.54 | $524.81 | $6,165.95 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $524.81 Median $4,073.80 Typical High $11,748.98 | Professional | None | $524.81 | $4,073.80 | $11,748.98 |
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 $223.87 Median $2,511.89 Typical High $3,235.94 | Professional | 52 · Reduced service | $223.87 | $2,511.89 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $1,023.29 Typical High $1,288.25 | Professional | 53 · Discontinued | $89.13 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $3,801.89 Typical High $4,786.30 | Professional | 54 · Surgery only | $338.84 | $3,801.89 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $758.58 Typical High $954.99 | Professional | 55 · Aftercare only | $67.61 | $758.58 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $512.86 Typical High $645.65 | Professional | 56 · Pre-op care only | $44.67 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $3,548.13 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $316.23 | $3,548.13 | $4,466.84 |
Where Colorado sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.