How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,512 to $17,783Professionalmedian $1,349 · 10th to 90th $933 to $2,138
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 $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $3,235.94 | Professional | None | $912.01 | $933.25 | $3,235.94 |
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 $1,047.13 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,479.11 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $5,370.32 Typical High $9,772.37 | Facility | None | $954.99 | $5,370.32 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,318.26 | $1,778.28 |
Denver HMP Setting Facility Modifier None Typical Low $933.25 Median $1,230.27 Typical High $2,041.74 | Facility | None | $933.25 | $1,230.27 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,737.80 | Professional | None | $831.76 | $1,174.90 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $1,659.59 Typical High $8,511.38 | Facility | None | $831.76 | $1,659.59 | $8,511.38 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,621.81 | Professional | None | $575.44 | $831.76 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,348.96 | $2,089.30 |
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 $467.74 Median $467.74 Typical High $588.84 | Professional | 52 · Reduced service | $467.74 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $234.42 | Professional | 53 · Discontinued | $186.21 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $891.25 | Professional | 54 · Surgery only | $691.83 | $691.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $177.83 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $831.76 |
Where Colorado sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.