How much rates vary
Facilitymedian $2,455 · 10th to 90th $724 to $8,913Professionalmedian $398 · 10th to 90th $302 to $1,072
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 $288.40 Median $346.74 Typical High $562.34 | Professional | None | $288.40 | $346.74 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $316.23 Median $380.19 Typical High $549.54 | Professional | None | $316.23 | $380.19 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $575.44 Typical High $812.83 | Professional | 50 · Both sides | $467.74 | $575.44 | $812.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $457.09 | Professional | None | $331.13 | $346.74 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,089.30 Typical High $3,311.31 | Facility | None | $758.58 | $2,089.30 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $676.08 | Professional | None | $288.40 | $354.81 | $676.08 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $1,584.89 Typical High $26,302.68 | Facility | None | $467.74 | $1,584.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $3,630.78 | Professional | None | $331.13 | $575.44 | $3,630.78 |
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 $295.12 Median $407.38 Typical High $676.08 | Professional | None | $295.12 | $407.38 | $676.08 |
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 $144.54 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $144.54 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $69.18 Typical High $75.86 | Professional | 53 · Discontinued | $57.54 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $218.78 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $43.65 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.84 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $204.17 | $245.47 | $269.15 |
Where Missouri sits
The same service costs 5.4 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 $6,102MT $1,125
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.