How much rates vary
Facilitymedian $933 · 10th to 90th $141 to $4,677Professionalmedian $537 · 10th to 90th $427 to $3,467
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 $537.03 Median $2,570.40 Typical High $6,309.57 | Facility | None | $537.03 | $2,570.40 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $645.65 | Professional | None | $389.05 | $489.78 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $741.31 | Professional | None | $426.58 | $512.86 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $758.58 Typical High $1,122.02 | Professional | 50 · Both sides | $645.65 | $758.58 | $1,122.02 |
BCBS Kansas City Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $707.95 | Professional | None | $457.09 | $549.54 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $199.53 Typical High $1,659.59 | Facility | None | $134.90 | $199.53 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $954.99 | Professional | None | $389.05 | $524.81 | $954.99 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $12,022.64 | Facility | None | $151.36 | $660.69 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $3,467.37 Typical High $3,801.89 | Professional | None | $537.03 | $3,467.37 | $3,801.89 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $977.24 | Professional | None | $426.58 | $575.44 | $977.24 |
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 $269.15 | Professional | 52 · Reduced service | $194.98 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $93.33 Typical High $107.15 | Professional | 53 · Discontinued | $79.43 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $354.81 Typical High $407.38 | Professional | 54 · Surgery only | $295.12 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $70.79 Typical High $81.28 | Professional | 55 · Aftercare only | $58.88 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $46.77 Typical High $53.70 | Professional | 56 · Pre-op care only | $38.90 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $331.13 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $275.42 | $331.13 | $380.19 |
Where Missouri sits
The same service costs 4.7 times more in New York than in Florida. 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
NY $3,038FL $649
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.