How much rates vary
Facilitymedian $1,820 · 10th to 90th $525 to $5,623Professionalmedian $794 · 10th to 90th $661 to $2,042
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 $1,071.52 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,071.52 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,548.82 | Professional | None | $588.84 | $691.83 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | None | $676.08 | $794.33 | $1,258.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $977.24 | Professional | None | $741.31 | $794.33 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $2,818.38 | Facility | None | $602.56 | $2,187.76 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,698.24 | Professional | None | $660.69 | $870.96 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $16,218.10 | Facility | None | $630.96 | $1,862.09 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,513.56 Typical High $5,888.44 | Professional | None | $691.83 | $1,513.56 | $5,888.44 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,548.82 | Professional | None | $660.69 | $954.99 | $1,548.82 |
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 $295.12 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $295.12 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $117.49 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $436.52 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $87.10 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $537.03 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Georgia. 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 $7,038GA $2,000
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.