How much rates vary
Facilitymedian $20,417 · 10th to 90th $4,169 to $43,652Professionalmedian $537 · 10th to 90th $380 to $851
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 $1,513.56 Median $4,168.69 Typical High $10,000.00 | Facility | None | $1,513.56 | $4,168.69 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $588.84 | Professional | None | $380.19 | $380.19 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,848.93 Median $20,892.96 Typical High $50,118.72 | Facility | None | $15,848.93 | $20,892.96 | $50,118.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $933.25 | Professional | None | $446.68 | $630.96 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $20,892.96 Typical High $29,512.09 | Facility | None | $588.84 | $20,892.96 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $707.95 | Professional | None | $407.38 | $489.78 | $707.95 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $537.03 Typical High $933.25 | Facility | None | $380.19 | $537.03 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $741.31 | Professional | None | $371.54 | $501.19 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $741.31 Typical High $25,703.96 | Facility | None | $371.54 | $741.31 | $25,703.96 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $562.34 | Professional | None | $371.54 | $398.11 | $562.34 |
United Setting Facility Modifier None Typical Low $7,413.10 Median $21,379.62 Typical High $42,657.95 | Facility | None | $7,413.10 | $21,379.62 | $42,657.95 |
United Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $794.33 | Professional | None | $407.38 | $537.03 | $794.33 |
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 $190.55 Median $190.55 Typical High $194.98 | Professional | 52 · Reduced service | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 53 · Discontinued | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 54 · Surgery only | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $269.15 |
Where Colorado sits
The same service costs 29.4 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 $37,066MT $1,262
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.