How much rates vary
Facilitymedian $1,514 · 10th to 90th $417 to $5,370Professionalmedian $288 · 10th to 90th $200 to $575
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 $380.19 Median $3,548.13 Typical High $7,585.78 | Facility | None | $380.19 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $575.44 | Professional | None | $218.78 | $245.47 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $5,754.40 | Facility | None | $389.05 | $1,000.00 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $501.19 | Professional | None | $190.55 | $288.40 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $436.52 Typical High $812.83 | Professional | 50 · Both sides | $323.59 | $436.52 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,949.84 Typical High $2,454.71 | Facility | None | $398.11 | $1,949.84 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $575.44 | Professional | None | $239.88 | $331.13 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $478.63 | Professional | None | $199.53 | $245.47 | $478.63 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $588.84 | Professional | None | $218.78 | $323.59 | $588.84 |
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 $109.65 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $109.65 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $43.65 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $162.18 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $194.98 |
Where Georgia sits
The same service costs 9.6 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 $6,197MT $647
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.