How much rates vary
Facilitymedian $1,950 · 10th to 90th $603 to $5,623Professionalmedian $331 · 10th to 90th $282 to $3,020
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 $977.24 Median $3,715.35 Typical High $6,760.83 | Facility | None | $977.24 | $3,715.35 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $562.34 | Professional | None | $257.04 | $275.42 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,995.26 Typical High $3,548.13 | Facility | None | $691.83 | $1,995.26 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $575.44 | Professional | None | $288.40 | $302.00 | $575.44 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $1,862.09 Typical High $9,332.54 | Facility | None | $478.63 | $1,862.09 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $3,019.95 | Professional | None | $302.00 | $446.68 | $3,019.95 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,089.30 Typical High $5,623.41 | Facility | None | $794.33 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $630.96 | Professional | None | $288.40 | $346.74 | $630.96 |
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 $154.88 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $229.09 |
Where Arizona sits
The same service costs 6.3 times more in Colorado 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
CO $6,515MT $1,038
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.