How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,000 to $7,079Professionalmedian $513 · 10th to 90th $372 to $2,884
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 $3,715.35 Typical High $7,762.47 | Facility | None | $549.54 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $630.96 | Professional | None | $331.13 | $446.68 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $371.54 Median $426.58 Typical High $645.65 | Professional | None | $371.54 | $426.58 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $630.96 Typical High $954.99 | Professional | 50 · Both sides | $562.34 | $630.96 | $954.99 |
BCBS Kansas City Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $676.08 | Professional | None | $380.19 | $537.03 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $2,187.76 | Facility | None | $602.56 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $891.25 | Professional | None | $323.59 | $537.03 | $891.25 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $2,344.23 Typical High $16,218.10 | Facility | None | $645.65 | $2,344.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $2,884.03 Typical High $4,677.35 | Professional | None | $575.44 | $2,884.03 | $4,677.35 |
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 $398.11 Median $575.44 Typical High $891.25 | Professional | None | $398.11 | $575.44 | $891.25 |
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 $165.96 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $165.96 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $89.13 Typical High $109.65 | Professional | 53 · Discontinued | $66.07 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $251.19 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $50.12 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.11 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $234.42 | $316.23 | $389.05 |
Where Missouri sits
The same service costs 4.7 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 $6,464MT $1,390
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.