How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,698 to $9,120Professionalmedian $479 · 10th to 90th $363 to $776
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 $588.84 Median $3,548.13 Typical High $10,715.19 | Facility | None | $588.84 | $3,548.13 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $1,778.28 | Professional | None | $331.13 | $380.19 | $1,778.28 |
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 $380.19 Median $537.03 Typical High $794.33 | Professional | None | $380.19 | $537.03 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,398.83 Typical High $3,235.94 | Facility | None | $691.83 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $645.65 | Professional | None | $363.08 | $478.63 | $645.65 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $645.65 | Facility | None | $380.19 | $457.09 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $645.65 | Professional | None | $309.03 | $436.52 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,884.03 | Facility | None | $309.03 | $616.60 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $602.56 | Professional | None | $218.78 | $309.03 | $602.56 |
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 $380.19 Median $478.63 Typical High $741.31 | Professional | None | $380.19 | $478.63 | $741.31 |
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 $169.82 Median $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $169.82 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $85.11 | Professional | 53 · Discontinued | $67.61 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $251.19 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $295.12 |
Where Colorado sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.