How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,175 to $12,882Professionalmedian $1,096 · 10th to 90th $741 to $2,399
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 $1,174.90 Median $4,466.84 Typical High $16,218.10 | Facility | None | $1,174.90 | $4,466.84 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,174.90 | Professional | None | $676.08 | $794.33 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $5,370.32 Typical High $12,302.69 | Facility | None | $1,318.26 | $5,370.32 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,621.81 | Professional | None | $851.14 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $177.83 Typical High $263.03 | Professional | 80 · Assistant surgeon | $138.04 | $177.83 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $158.49 Typical High $229.09 | Professional | AS · PA/NP assist | $120.23 | $158.49 | $229.09 |
BCBS Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,047.13 | Professional | None | $707.95 | $758.58 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $2,691.53 | Facility | None | $588.84 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,778.28 | Professional | None | $660.69 | $891.25 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $5,011.87 Typical High $12,882.50 | Facility | None | $1,122.02 | $5,011.87 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,412.54 Typical High $13,182.57 | Professional | None | $851.14 | $1,412.54 | $13,182.57 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,786.30 Typical High $16,218.10 | Facility | None | $977.24 | $4,786.30 | $16,218.10 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,584.89 | Professional | None | $724.44 | $1,071.52 | $1,584.89 |
5 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 $338.84 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $338.84 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $134.90 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $660.69 | Professional | 54 · Surgery only | $501.19 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $89.13 |
Where Missouri sits
The same service costs 4.6 times more in Alaska 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
AK $9,843KY $2,122
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.