How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,349 to $8,913Professionalmedian $871 · 10th to 90th $550 to $1,318
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 $707.95 Median $3,235.94 Typical High $10,964.78 | Facility | None | $707.95 | $3,235.94 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $1,202.26 | Professional | None | $537.03 | $562.34 | $1,202.26 |
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 $691.83 Median $977.24 Typical High $1,445.44 | Professional | None | $691.83 | $977.24 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,454.71 Typical High $3,801.89 | Facility | None | $933.25 | $2,454.71 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,122.02 | Professional | None | $537.03 | $758.58 | $1,122.02 |
Denver HMP Setting Facility Modifier None Typical Low $549.54 Median $707.95 Typical High $1,096.48 | Facility | None | $549.54 | $707.95 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,174.90 | Professional | None | $549.54 | $776.25 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $1,122.02 Typical High $2,884.03 | Facility | None | $549.54 | $1,122.02 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $1,071.52 | Professional | None | $389.05 | $549.54 | $1,071.52 |
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 $602.56 Median $776.25 Typical High $1,258.93 | Professional | None | $602.56 | $776.25 | $1,258.93 |
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 $275.42 Median $275.42 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $128.82 | Professional | 53 · Discontinued | $109.65 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $407.38 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $446.68 |
Where Colorado sits
The same service costs 3.6 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 $6,446MT $1,806
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.