How much rates vary
Facilitymedian $1,905 · 10th to 90th $525 to $5,623Professionalmedian $479 · 10th to 90th $355 to $2,818
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 $512.86 Median $3,715.35 Typical High $7,762.47 | Facility | None | $512.86 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $549.54 | Professional | None | $316.23 | $416.87 | $549.54 |
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 $338.84 Median $380.19 Typical High $562.34 | Professional | None | $338.84 | $380.19 | $562.34 |
BCBS Kansas City Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $660.69 | Professional | None | $380.19 | $524.81 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $2,187.76 | Facility | None | $602.56 | $954.99 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $812.83 | Professional | None | $316.23 | $489.78 | $812.83 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $2,691.53 Typical High $16,218.10 | Facility | None | $549.54 | $2,691.53 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $2,818.38 Typical High $3,630.78 | Professional | None | $489.78 | $2,818.38 | $3,630.78 |
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 $354.81 Median $501.19 Typical High $831.76 | Professional | None | $354.81 | $501.19 | $831.76 |
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 $158.49 Median $208.93 Typical High $257.04 | Professional | 52 · Reduced service | $158.49 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $83.18 Typical High $102.33 | Professional | 53 · Discontinued | $64.57 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $316.23 Typical High $389.05 | Professional | 54 · Surgery only | $239.88 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $77.62 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $41.69 Typical High $51.29 | Professional | 56 · Pre-op care only | $31.62 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $295.12 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $223.87 | $295.12 | $363.08 |
Where Missouri sits
The same service costs 3.7 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 $4,890MT $1,327
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.