How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,479 to $14,791Professionalmedian $1,148 · 10th to 90th $813 to $1,862
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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $5,495.41 | Professional | None | $812.83 | $812.83 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,905.46 | Professional | None | $912.01 | $1,288.25 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,691.53 Typical High $5,128.61 | Facility | None | $436.52 | $2,691.53 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,513.56 | Professional | None | $794.33 | $1,122.02 | $1,513.56 |
Denver HMP Setting Facility Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,819.70 | Facility | None | $724.44 | $1,023.29 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,513.56 | Professional | None | $724.44 | $1,023.29 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $1,445.44 Typical High $4,570.88 | Facility | None | $724.44 | $1,445.44 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,412.54 | Professional | None | $501.19 | $724.44 | $1,412.54 |
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 $912.01 Median $1,148.15 Typical High $1,778.28 | Professional | None | $912.01 | $1,148.15 | $1,778.28 |
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 $407.38 Median $407.38 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $707.95 |
Where Colorado sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $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.