How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,148 to $8,913Professionalmedian $708 · 10th to 90th $525 to $2,042
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 $1,698.24 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $707.95 | Professional | None | $478.63 | $575.44 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,585.78 | Facility | None | $1,318.26 | $3,467.37 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $954.99 | Professional | None | $562.34 | $707.95 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,071.52 Typical High $1,412.54 | Professional | 50 · Both sides | $851.14 | $1,071.52 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $446.68 Typical High $660.69 | Professional | 62 · Two surgeons | $354.81 | $446.68 | $660.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $758.58 | Professional | None | $537.03 | $575.44 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,089.30 Typical High $3,311.31 | Facility | None | $758.58 | $2,089.30 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,174.90 | Professional | None | $478.63 | $616.60 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $3,715.35 Typical High $26,302.68 | Facility | None | $776.25 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $4,168.69 | Professional | None | $575.44 | $954.99 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,148.15 | Professional | None | $501.19 | $724.44 | $1,148.15 |
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 $239.88 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $398.11 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $398.11 | $446.68 |
Where Missouri sits
The same service costs 4.1 times more in Wisconsin 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
WI $7,505MT $1,845
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.