How much rates vary
Facilitymedian $2,344 · 10th to 90th $692 to $6,607Professionalmedian $380 · 10th to 90th $288 to $1,175
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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $416.87 | Professional | None | $275.42 | $331.13 | $416.87 |
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 $302.00 Median $363.08 Typical High $512.86 | Professional | None | $302.00 | $363.08 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $537.03 Typical High $758.58 | Professional | 50 · Both sides | $446.68 | $537.03 | $758.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $436.52 | Professional | None | $309.03 | $331.13 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,187.76 | Facility | None | $602.56 | $1,122.02 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $645.65 | Professional | None | $275.42 | $346.74 | $645.65 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $1,584.89 Typical High $16,218.10 | Facility | None | $467.74 | $1,584.89 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $549.54 Typical High $3,388.44 | Professional | None | $309.03 | $549.54 | $3,388.44 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $645.65 | Professional | None | $281.84 | $389.05 | $645.65 |
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 $138.04 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $66.07 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $208.93 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.11 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $194.98 | $234.42 | $257.04 |
Where Missouri sits
The same service costs 4.6 times more in Colorado 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
CO $4,822MT $1,050
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.