How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,479 to $6,918Professionalmedian $1,175 · 10th to 90th $851 to $1,622
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 $1,047.13 Median $1,819.70 Typical High $3,311.31 | Facility | None | $1,047.13 | $1,819.70 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,047.13 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $5,248.07 Typical High $7,244.36 | Facility | None | $2,691.53 | $5,248.07 | $7,244.36 |
BCBS Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $3,388.44 | Facility | None | $1,122.02 | $2,754.23 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,445.44 Typical High $1,584.89 | Professional | None | $660.69 | $1,445.44 | $1,584.89 |
Qualchoice Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,380.38 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,412.54 | $1,995.26 | $6,918.31 |
United Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,737.80 | Professional | None | $812.83 | $954.99 | $1,737.80 |
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 $501.19 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $218.78 | Professional | 53 · Discontinued | $204.17 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $758.58 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $758.58 |
Where Arkansas sits
The same service costs 4.2 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 $11,551MT $2,762
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.