How much rates vary
Facilitymedian $4,365 · 10th to 90th $813 to $8,913Professionalmedian $417 · 10th to 90th $275 to $631
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 $281.84 Median $3,090.30 Typical High $8,912.51 | Facility | None | $281.84 | $3,090.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $524.81 | Professional | None | $239.88 | $281.84 | $524.81 |
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 $316.23 Median $457.09 Typical High $691.83 | Professional | None | $316.23 | $457.09 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,311.31 | Facility | None | $588.84 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $537.03 | Professional | None | $275.42 | $380.19 | $537.03 |
Denver HMP Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $467.74 | Facility | None | $239.88 | $338.84 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $549.54 | Professional | None | $251.19 | $371.54 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $575.44 Typical High $2,884.03 | Facility | None | $309.03 | $575.44 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $602.56 | Professional | None | $162.18 | $309.03 | $602.56 |
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 $288.40 Median $380.19 Typical High $616.60 | Professional | None | $288.40 | $380.19 | $616.60 |
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 $120.23 Median $141.25 Typical High $151.36 | Professional | 52 · Reduced service | $120.23 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $60.26 | Professional | 53 · Discontinued | $47.86 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $213.80 Typical High $229.09 | Professional | 54 · Surgery only | $177.83 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $42.66 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $199.53 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $165.96 | $199.53 | $213.80 |
Where Colorado sits
The same service costs 5.6 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 $4,849MT $864
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.