How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,000 to $7,079Professionalmedian $407 · 10th to 90th $282 to $1,549
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 $363.08 Median $3,715.35 Typical High $7,762.47 | Facility | None | $363.08 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $549.54 | Professional | None | $213.80 | $295.12 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $602.56 | Professional | None | $288.40 | $380.19 | $602.56 |
BCBS Kansas City Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $467.74 | Professional | None | $263.03 | $407.38 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $2,187.76 | Facility | None | $602.56 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $660.69 | Professional | None | $275.42 | $407.38 | $660.69 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $2,398.83 Typical High $16,218.10 | Facility | None | $501.19 | $2,398.83 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $2,137.96 Typical High $3,019.95 | Professional | None | $371.54 | $2,137.96 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $691.83 | Professional | None | $257.04 | $398.11 | $691.83 |
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 $107.15 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $107.15 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $60.26 Typical High $72.44 | Professional | 53 · Discontinued | $42.66 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $158.49 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $31.62 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.38 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $208.93 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $147.91 | $208.93 | $251.19 |
Where Missouri sits
The same service costs 6.1 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 $6,346MT $1,043
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.