How much rates vary
Facilitymedian $1,122 · 10th to 90th $155 to $5,012Professionalmedian $490 · 10th to 90th $389 to $3,236
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 $501.19 Median $3,162.28 Typical High $7,762.47 | Facility | None | $501.19 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $537.03 | Professional | None | $363.08 | $436.52 | $537.03 |
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 $380.19 Median $457.09 Typical High $630.96 | Professional | None | $380.19 | $457.09 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $676.08 Typical High $954.99 | Professional | 50 · Both sides | $575.44 | $676.08 | $954.99 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $660.69 | Professional | None | $426.58 | $512.86 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,122.02 Typical High $1,659.59 | Facility | None | $446.68 | $1,122.02 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $851.14 | Professional | None | $363.08 | $489.78 | $851.14 |
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 $489.78 Median $3,235.94 Typical High $3,548.13 | Professional | None | $489.78 | $3,235.94 | $3,548.13 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $3,548.13 | Facility | None | $123.03 | $602.56 | $3,548.13 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $891.25 | Professional | None | $389.05 | $524.81 | $891.25 |
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 $181.97 Median $218.78 Typical High $251.19 | Professional | 52 · Reduced service | $181.97 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $87.10 Typical High $100.00 | Professional | 53 · Discontinued | $72.44 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $275.42 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $54.95 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $257.04 | $309.03 | $346.74 |
Where Missouri sits
The same service costs 5.3 times more in Colorado 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
CO $4,377FL $831
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.