How much rates vary
Facilitymedian $676 · 10th to 90th $115 to $3,631Professionalmedian $339 · 10th to 90th $240 to $2,089
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 $295.12 Median $3,162.28 Typical High $7,762.47 | Facility | None | $295.12 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $416.87 | Professional | None | $239.88 | $295.12 | $416.87 |
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 $239.88 Median $288.40 Typical High $446.68 | Professional | None | $239.88 | $288.40 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $478.63 | Professional | None | $302.00 | $380.19 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $141.25 Typical High $199.53 | Facility | None | $58.88 | $141.25 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $588.84 | Professional | None | $239.88 | $338.84 | $588.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $398.11 Typical High $1,548.82 | Facility | None | $54.95 | $398.11 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $2,089.30 Typical High $2,454.71 | Professional | None | $346.74 | $2,089.30 | $2,454.71 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $602.56 | Professional | None | $257.04 | $363.08 | $602.56 |
7 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 $120.23 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $57.54 Typical High $69.18 | Professional | 53 · Discontinued | $47.86 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $213.80 Typical High $257.04 | Professional | 54 · Surgery only | $177.83 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $43.65 Typical High $51.29 | Professional | 55 · Aftercare only | $35.48 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.84 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.99 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $165.96 | $199.53 | $239.88 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $316.23 | $316.23 | $316.23 |
Where Missouri sits
The same service costs 6.7 times more in New York 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
NY $2,828FL $419
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.