How much rates vary
Facilitymedian $661 · 10th to 90th $115 to $3,548Professionalmedian $309 · 10th to 90th $214 to $2,042
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 $2,511.89 Typical High $7,762.47 | Facility | None | $295.12 | $2,511.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $363.08 | Professional | None | $199.53 | $275.42 | $363.08 |
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 $213.80 Median $263.03 Typical High $416.87 | Professional | None | $213.80 | $263.03 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $467.74 | Professional | None | $309.03 | $363.08 | $467.74 |
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 $229.09 Median $309.03 Typical High $537.03 | Professional | None | $229.09 | $309.03 | $537.03 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $380.19 Typical High $1,288.25 | Facility | None | $54.95 | $380.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $2,041.74 Typical High $2,238.72 | Professional | None | $302.00 | $2,041.74 | $2,238.72 |
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 $239.88 Median $331.13 Typical High $562.34 | Professional | None | $239.88 | $331.13 | $562.34 |
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 $112.20 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $112.20 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $45.71 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $208.93 Typical High $229.09 | Professional | 54 · Surgery only | $169.82 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $33.88 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.91 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $194.98 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $158.49 | $194.98 | $213.80 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $194.98 | $194.98 | $194.98 |
Where Missouri sits
The same service costs 6.4 times more in Colorado 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
CO $2,602FL $408
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.