How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,175 to $8,913Professionalmedian $562 · 10th to 90th $427 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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $549.54 | Professional | None | $389.05 | $467.74 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $776.25 | Professional | None | $457.09 | $575.44 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $870.96 Typical High $1,148.15 | Professional | 50 · Both sides | $676.08 | $870.96 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $363.08 Typical High $489.78 | Professional | 62 · Two surgeons | $281.84 | $363.08 | $489.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $616.60 | Professional | None | $436.52 | $467.74 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $5,248.07 | Facility | None | $1,202.26 | $2,137.96 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $933.25 | Professional | None | $389.05 | $489.78 | $933.25 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $3,715.35 Typical High $26,302.68 | Facility | None | $676.08 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $3,801.89 | Professional | None | $457.09 | $758.58 | $3,801.89 |
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 $407.38 Median $575.44 Typical High $912.01 | Professional | None | $407.38 | $575.44 | $912.01 |
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 $194.98 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $194.98 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $295.12 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $58.88 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $323.59 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $275.42 | $323.59 | $363.08 |
Where Missouri sits
The same service costs 5.1 times more in Washington, DC 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
DC $7,757MT $1,518
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.