How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,096 to $15,136Professionalmedian $933 · 10th to 90th $661 to $1,950
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 $5,623.41 Typical High $13,182.57 | Facility | None | $1,071.52 | $5,623.41 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,023.29 | Professional | None | $489.78 | $645.65 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $4,265.80 Typical High $16,982.44 | Facility | None | $1,412.54 | $4,265.80 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,318.26 | Professional | None | $691.83 | $933.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,412.54 Typical High $1,949.84 | Professional | 50 · Both sides | $1,047.13 | $1,412.54 | $1,949.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,202.26 | Professional | None | $630.96 | $891.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $12,022.64 | Facility | None | $851.14 | $2,238.72 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,737.80 | Professional | None | $660.69 | $891.25 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $26,302.68 | Facility | None | $954.99 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $5,011.87 Typical High $6,165.95 | Professional | None | $794.33 | $5,011.87 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $6,456.54 | Facility | None | $1,000.00 | $2,818.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,548.82 | Professional | None | $645.65 | $933.25 | $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 $245.47 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $245.47 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $123.03 Typical High $147.91 | Professional | 53 · Discontinued | $100.00 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $457.09 Typical High $549.54 | Professional | 54 · Surgery only | $371.54 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $91.20 Typical High $109.65 | Professional | 55 · Aftercare only | $74.13 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $61.66 Typical High $74.13 | Professional | 56 · Pre-op care only | $48.98 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $426.58 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $346.74 | $426.58 | $512.86 |
Where Missouri sits
The same service costs 3.7 times more in Connecticut than in Arkansas. 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
CT $7,673AR $2,094
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.