How much rates vary
Facilitymedian $2,042 · 10th to 90th $575 to $6,310Professionalmedian $513 · 10th to 90th $363 to $2,692
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 $512.86 Median $4,677.35 Typical High $7,762.47 | Facility | None | $512.86 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $660.69 | Professional | None | $302.00 | $446.68 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $588.84 | Professional | None | $371.54 | $446.68 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $660.69 Typical High $891.25 | Professional | 50 · Both sides | $549.54 | $660.69 | $891.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $691.83 | Professional | None | $354.81 | $549.54 | $691.83 |
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 $302.00 Median $512.86 Typical High $851.14 | Professional | None | $302.00 | $512.86 | $851.14 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $2,398.83 Typical High $26,302.68 | Facility | None | $660.69 | $2,398.83 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $2,691.53 Typical High $3,981.07 | Professional | None | $588.84 | $2,691.53 | $3,981.07 |
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 $371.54 Median $562.34 Typical High $870.96 | Professional | None | $371.54 | $562.34 | $870.96 |
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 $151.36 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $151.36 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $60.26 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $223.87 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $44.67 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $30.20 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $208.93 | $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 $6,438MT $1,383
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.