How much rates vary
Facilitymedian $1,413 · 10th to 90th $427 to $4,169Professionalmedian $417 · 10th to 90th $245 to $589
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 $245.47 Median $524.81 Typical High $2,884.03 | Facility | None | $245.47 | $524.81 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $562.34 | Professional | None | $245.47 | $416.87 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $426.58 | Professional | None | $77.62 | $154.88 | $426.58 |
BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $2,454.71 | Facility | None | $1,412.54 | $1,445.44 | $2,454.71 |
BCBS Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $398.11 | Professional | None | $269.15 | $380.19 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $537.03 | Professional | None | $380.19 | $389.05 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $363.08 Typical High $891.25 | Professional | None | $158.49 | $363.08 | $891.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $257.04 Median $1,513.56 Typical High $4,466.84 | Facility | None | $257.04 | $1,513.56 | $4,466.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $251.19 Median $512.86 Typical High $588.84 | Professional | None | $251.19 | $512.86 | $588.84 |
Priority Health Setting Professional Modifier None Typical Low $141.25 Median $323.59 Typical High $724.44 | Professional | None | $141.25 | $323.59 | $724.44 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $588.84 | Professional | None | $257.04 | $389.05 | $588.84 |
14 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 $123.03 Median $190.55 Typical High $269.15 | Professional | 52 · Reduced service | $123.03 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $75.86 Typical High $107.15 | Professional | 53 · Discontinued | $48.98 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $281.84 Typical High $398.11 | Professional | 54 · Surgery only | $181.97 | $281.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $56.23 Typical High $79.43 | Professional | 55 · Aftercare only | $37.15 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $38.02 Typical High $53.70 | Professional | 56 · Pre-op care only | $24.55 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $263.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $169.82 | $263.03 | $371.54 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 50 · Both sides | $645.65 | $645.65 | $645.65 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 50 · Both sides | $426.58 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $181.97 Typical High $281.84 | Professional | 52 · Reduced service | $120.23 | $181.97 | $281.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $72.44 Typical High $112.20 | Professional | 53 · Discontinued | $47.86 | $72.44 | $112.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $275.42 Typical High $416.87 | Professional | 54 · Surgery only | $181.97 | $275.42 | $416.87 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $54.95 Typical High $85.11 | Professional | 55 · Aftercare only | $36.31 | $54.95 | $85.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $36.31 Typical High $56.23 | Professional | 56 · Pre-op care only | $23.99 | $36.31 | $56.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $257.04 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $169.82 | $257.04 | $389.05 |
Where Michigan sits
The same service costs 4.6 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 $4,728MT $1,029
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.