How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,549 to $15,488Professionalmedian $1,479 · 10th to 90th $1,096 to $2,239
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 $1,000.00 Median $3,311.31 Typical High $13,489.63 | Facility | None | $1,000.00 | $3,311.31 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,122.02 | $2,089.30 |
BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,778.28 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $9,120.11 Typical High $11,748.98 | Facility | None | $1,862.09 | $9,120.11 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,288.25 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $4,365.16 | Professional | None | $1,096.48 | $1,819.70 | $4,365.16 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,412.54 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $4,897.79 Typical High $15,848.93 | Facility | None | $1,513.56 | $4,897.79 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,513.56 | $2,454.71 |
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 $489.78 Median $562.34 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $223.87 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $112.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $776.25 | $812.83 |
Where Illinois sits
The same service costs 4.8 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 $16,076MT $3,358
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.