How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,820 to $11,482Professionalmedian $1,905 · 10th to 90th $1,023 to $4,898
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 $4,365.16 Median $7,244.36 Typical High $17,378.01 | Facility | None | $4,365.16 | $7,244.36 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,445.44 | Professional | None | $794.33 | $794.33 | $1,445.44 |
BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $8,912.51 Typical High $18,197.01 | Facility | None | $6,760.83 | $8,912.51 | $18,197.01 |
BCBS Setting Professional Modifier None Typical Low $4,168.69 Median $4,466.84 Typical High $4,897.79 | Professional | None | $4,168.69 | $4,466.84 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $6,456.54 Typical High $6,760.83 | Facility | None | $5,495.41 | $6,456.54 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,905.46 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $12,022.64 | Facility | None | $1,513.56 | $3,467.37 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $6,456.54 | Professional | None | $1,023.29 | $1,949.84 | $6,456.54 |
Midlands Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,905.46 | $2,511.89 |
Midlands Setting Facility Modifier None Typical Low $5,495.41 Median $6,456.54 Typical High $9,549.93 | Facility | None | $5,495.41 | $6,456.54 | $9,549.93 |
Midlands Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,479.11 | $2,041.74 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,912.51 | Facility | None | $1,698.24 | $3,801.89 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,698.24 | $2,344.23 |
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 $398.11 Median $398.11 Typical High $676.08 | Professional | 52 · Reduced service | $398.11 | $398.11 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $275.42 | Professional | 53 · Discontinued | $158.49 | $158.49 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $1,023.29 | Professional | 54 · Surgery only | $588.84 | $588.84 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $204.17 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $134.90 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $954.99 |
Where Nebraska sits
The same service costs 5.1 times more in Oklahoma than in Kentucky. 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
OK $11,738KY $2,311
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.