How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,148 to $10,471Professionalmedian $776 · 10th to 90th $617 to $1,862
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 $562.34 Median $691.83 Typical High $870.96 | Professional | None | $562.34 | $691.83 | $870.96 |
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 $645.65 Median $741.31 Typical High $1,096.48 | Professional | None | $645.65 | $741.31 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,122.02 Typical High $1,659.59 | Professional | 50 · Both sides | $977.24 | $1,122.02 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $467.74 Typical High $691.83 | Professional | 62 · Two surgeons | $407.38 | $467.74 | $691.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $912.01 | Professional | None | $645.65 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,630.78 Typical High $5,370.32 | Facility | None | $758.58 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,348.96 | Professional | None | $562.34 | $707.95 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,801.89 Typical High $26,302.68 | Facility | None | $891.25 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,148.15 Typical High $5,623.41 | Professional | None | $676.08 | $1,148.15 | $5,623.41 |
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 $588.84 Median $851.14 Typical High $1,318.26 | Professional | None | $588.84 | $851.14 | $1,318.26 |
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 $281.84 Median $346.74 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $138.04 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $524.81 Typical High $549.54 | Professional | 54 · Surgery only | $416.87 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $104.71 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $69.18 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $389.05 | $489.78 | $512.86 |
Where Missouri sits
The same service costs 4.8 times more in Alaska 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
AK $10,454MT $2,169
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.