How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,096 to $8,913Professionalmedian $692 · 10th to 90th $513 to $1,660
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 $812.83 Median $4,677.35 Typical High $7,762.47 | Facility | None | $812.83 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $831.76 | Professional | None | $446.68 | $537.03 | $831.76 |
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 $562.34 Median $691.83 Typical High $933.25 | Professional | None | $562.34 | $691.83 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,047.13 Typical High $1,380.38 | Professional | 50 · Both sides | $831.76 | $1,047.13 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $436.52 Typical High $575.44 | Professional | 62 · Two surgeons | $346.74 | $436.52 | $575.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $724.44 | Professional | None | $501.19 | $537.03 | $724.44 |
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 $446.68 Median $588.84 Typical High $1,122.02 | Professional | None | $446.68 | $588.84 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $3,715.35 Typical High $26,302.68 | Facility | None | $776.25 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $933.25 Typical High $5,128.61 | Professional | None | $549.54 | $933.25 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,096.48 | Professional | None | $478.63 | $707.95 | $1,096.48 |
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 $223.87 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $223.87 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $331.13 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $407.38 |
Where Missouri sits
The same service costs 4.3 times more in Wisconsin 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
WI $7,406MT $1,722
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.