How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,288 to $8,913Professionalmedian $479 · 10th to 90th $355 to $759
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 $478.63 Median $3,235.94 Typical High $10,715.19 | Facility | None | $478.63 | $3,235.94 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $1,659.59 | Professional | None | $331.13 | $371.54 | $1,659.59 |
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 $524.81 Typical High $776.25 | Professional | None | $380.19 | $524.81 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,513.56 Typical High $3,311.31 | Facility | None | $831.76 | $1,513.56 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $630.96 | Professional | None | $354.81 | $467.74 | $630.96 |
Denver HMP Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $630.96 | Facility | None | $371.54 | $446.68 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $630.96 | Professional | None | $302.00 | $426.58 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $602.56 Typical High $1,659.59 | Facility | None | $302.00 | $602.56 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $588.84 | Professional | None | $213.80 | $302.00 | $588.84 |
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 $371.54 Median $467.74 Typical High $741.31 | Professional | None | $371.54 | $467.74 | $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 $165.96 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $288.40 |
Where Colorado sits
The same service costs 5.1 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 $5,094MT $991
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.