How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,096 to $8,913Professionalmedian $525 · 10th to 90th $417 to $1,349
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 $549.54 Median $5,128.61 Typical High $13,803.84 | Facility | None | $549.54 | $5,128.61 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $1,000.00 | Professional | None | $407.38 | $489.78 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $602.56 | Professional | None | $426.58 | $426.58 | $602.56 |
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 $446.68 Median $489.78 Typical High $724.44 | Professional | None | $446.68 | $489.78 | $724.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $630.96 | Professional | None | $457.09 | $478.63 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $5,248.07 | Facility | None | $1,202.26 | $2,137.96 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $954.99 | Professional | None | $398.11 | $501.19 | $954.99 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $26,302.68 | Facility | None | $724.44 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $3,548.13 | Professional | None | $478.63 | $794.33 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $933.25 | Professional | None | $416.87 | $588.84 | $933.25 |
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 $204.17 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $81.28 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $302.00 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $281.84 | $338.84 | $371.54 |
Where Missouri sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.