How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,514 to $13,183Professionalmedian $1,622 · 10th to 90th $871 to $3,020
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 $1,122.02 Median $9,549.93 Typical High $21,877.62 | Facility | None | $1,122.02 | $9,549.93 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,862.09 | Professional | None | $870.96 | $1,122.02 | $1,862.09 |
BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $25,118.86 | Facility | None | $9,332.54 | $12,302.69 | $25,118.86 |
BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,380.38 Typical High $1,905.46 | Professional | None | $776.25 | $1,380.38 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $4,073.80 Typical High $7,762.47 | Facility | None | $1,949.84 | $4,073.80 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $2,951.21 | Professional | None | $1,862.09 | $2,344.23 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $1,318.26 Median $2,951.21 Typical High $9,772.37 | Facility | None | $1,318.26 | $2,951.21 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $12,022.64 | Professional | None | $1,479.11 | $2,951.21 | $12,022.64 |
Midlands Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,754.23 | $3,162.28 |
Midlands Setting Facility Modifier None Typical Low $1,949.84 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,949.84 | $4,168.69 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $1,621.81 Median $2,884.03 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,884.03 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $3,019.95 Typical High $7,585.78 | Facility | None | $1,380.38 | $3,019.95 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,258.93 | $2,089.30 | $3,019.95 |
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 $436.52 Median $562.34 Typical High $741.31 | Professional | 52 · Reduced service | $436.52 | $562.34 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $223.87 Typical High $295.12 | Professional | 53 · Discontinued | $173.78 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $851.14 Typical High $1,096.48 | Professional | 54 · Surgery only | $660.69 | $851.14 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $169.82 Typical High $223.87 | Professional | 55 · Aftercare only | $131.83 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $112.20 Typical High $147.91 | Professional | 56 · Pre-op care only | $87.10 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $794.33 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $616.60 | $794.33 | $1,023.29 |
Where Nebraska sits
The same service costs 3.6 times more in Alaska 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
AK $11,388MT $3,177
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.