How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,230 to $8,913Professionalmedian $389 · 10th to 90th $234 to $741
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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $575.44 | Professional | None | $204.17 | $323.59 | $575.44 |
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 $251.19 Median $436.52 Typical High $741.31 | Professional | None | $251.19 | $436.52 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,445.44 Typical High $2,187.76 | Facility | None | $588.84 | $1,445.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $562.34 | Professional | None | $234.42 | $338.84 | $562.34 |
Denver HMP Setting Facility Modifier None Typical Low $204.17 Median $346.74 Typical High $501.19 | Facility | None | $204.17 | $346.74 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $602.56 | Professional | None | $199.53 | $346.74 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $630.96 Typical High $1,659.59 | Facility | None | $338.84 | $630.96 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $338.84 Typical High $660.69 | Professional | None | $125.89 | $338.84 | $660.69 |
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 $245.47 Median $380.19 Typical High $691.83 | Professional | None | $245.47 | $380.19 | $691.83 |
5 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 $102.33 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $102.33 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $64.57 Typical High $70.79 | Professional | 53 · Discontinued | $40.74 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $151.36 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.42 | $31.62 | $35.48 |
Where Colorado sits
The same service costs 7.9 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 $5,867MT $745
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.