How much rates vary
Facilitymedian $8,511 · 10th to 90th $2,570 to $15,488Professionalmedian $2,138 · 10th to 90th $1,479 to $3,311
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 $2,691.53 Median $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $3,388.44 | Professional | None | $1,380.38 | $1,479.11 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,344.23 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,168.69 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,995.26 | $2,691.53 |
Denver HMP Setting Facility Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,570.40 | Facility | None | $1,479.11 | $1,819.70 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,862.09 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $5,011.87 | Facility | None | $1,318.26 | $2,630.27 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,570.40 | Professional | None | $933.25 | $1,318.26 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,513.56 | $1,949.84 | $3,090.30 |
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 $691.83 Median $724.44 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,096.48 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,023.29 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $218.78 Typical High $234.42 | Professional | 55 · Aftercare only | $204.17 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,023.29 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $954.99 | $1,023.29 | $1,096.48 |
Where Colorado sits
The same service costs 3.0 times more in Alaska than in Vermont. 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 $12,999VT $4,294
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.