How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,288 to $8,913Professionalmedian $437 · 10th to 90th $302 to $708
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 $302.00 Median $302.00 Typical High $3,162.28 | Professional | None | $302.00 | $302.00 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $707.95 | Professional | None | $338.84 | $478.63 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,513.56 Typical High $3,311.31 | Facility | None | $831.76 | $1,513.56 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $575.44 | Professional | None | $323.59 | $426.58 | $575.44 |
Denver HMP Setting Facility Modifier None Typical Low $302.00 Median $398.11 Typical High $691.83 | Facility | None | $302.00 | $398.11 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $588.84 | Professional | None | $275.42 | $389.05 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $549.54 Typical High $1,659.59 | Facility | None | $275.42 | $549.54 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $537.03 | Professional | None | $194.98 | $275.42 | $537.03 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $660.69 | Professional | None | $331.13 | $426.58 | $660.69 |
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 $151.36 Median $151.36 Typical High $186.21 | Professional | 52 · Reduced service | $151.36 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $60.26 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $281.84 | Professional | 54 · Surgery only | $229.09 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $56.23 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $263.03 |
Where Colorado sits
The same service costs 6.6 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 $6,126MT $925
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.