How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,175 to $8,913Professionalmedian $851 · 10th to 90th $676 to $2,188
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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $891.25 | Professional | None | $676.08 | $794.33 | $891.25 |
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 $707.95 Median $776.25 Typical High $1,288.25 | Professional | None | $707.95 | $776.25 | $1,288.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,096.48 | Professional | None | $758.58 | $831.76 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,691.53 | Facility | None | $645.65 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,513.56 | Professional | None | $660.69 | $812.83 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,715.35 Typical High $26,302.68 | Facility | None | $891.25 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $5,888.44 | Professional | None | $776.25 | $1,318.26 | $5,888.44 |
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 $676.08 Median $933.25 Typical High $1,584.89 | Professional | None | $676.08 | $933.25 | $1,584.89 |
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 $338.84 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $338.84 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $134.90 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $512.86 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $478.63 | $549.54 | $630.96 |
Where Missouri sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.