How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,862 to $12,589Professionalmedian $794 · 10th to 90th $603 to $1,202
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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $812.83 | Professional | None | $575.44 | $602.56 | $812.83 |
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 $660.69 Median $891.25 Typical High $1,258.93 | Professional | None | $660.69 | $891.25 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,454.71 Typical High $3,311.31 | Facility | None | $831.76 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,047.13 | Professional | None | $588.84 | $741.31 | $1,047.13 |
Denver HMP Setting Facility Modifier None Typical Low $588.84 Median $724.44 Typical High $1,412.54 | Facility | None | $588.84 | $724.44 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,258.93 | Professional | None | $630.96 | $794.33 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,884.03 | Facility | None | $575.44 | $1,148.15 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $1,047.13 | Professional | None | $501.19 | $588.84 | $1,047.13 |
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 $575.44 Median $741.31 Typical High $1,174.90 | Professional | None | $575.44 | $741.31 | $1,174.90 |
7 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 $288.40 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $288.40 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $141.25 | Professional | 53 · Discontinued | $114.82 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $70.79 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $489.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $407.38 Typical High $616.60 | Professional | 62 · Two surgeons | $323.59 | $407.38 | $616.60 |
Where Colorado sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.