How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,349 to $8,913Professionalmedian $676 · 10th to 90th $513 to $1,096
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 $851.14 Median $3,715.35 Typical High $10,964.78 | Facility | None | $851.14 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,023.29 | Professional | None | $537.03 | $537.03 | $1,023.29 |
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 $512.86 Median $660.69 Typical High $1,096.48 | Professional | None | $512.86 | $660.69 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,621.81 Typical High $3,311.31 | Facility | None | $831.76 | $1,621.81 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $977.24 | Professional | None | $562.34 | $724.44 | $977.24 |
Denver HMP Setting Facility Modifier None Typical Low $537.03 Median $776.25 Typical High $1,000.00 | Facility | None | $537.03 | $776.25 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $794.33 | Professional | None | $398.11 | $524.81 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $812.83 Typical High $1,819.70 | Facility | None | $398.11 | $812.83 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $588.84 | Professional | None | $281.84 | $446.68 | $588.84 |
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 $602.56 Median $812.83 Typical High $1,258.93 | Professional | None | $602.56 | $812.83 | $1,258.93 |
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 $269.15 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $407.38 |
Where Colorado sits
The same service costs 4.6 times more in Oklahoma 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
OK $6,462MT $1,416
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.