How much rates vary
Facilitymedian $1,549 · 10th to 90th $447 to $4,898Professionalmedian $646 · 10th to 90th $468 to $3,715
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 $575.44 Median $3,162.28 Typical High $6,309.57 | Facility | None | $575.44 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $724.44 | Professional | None | $426.58 | $524.81 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $489.78 Median $602.56 Typical High $812.83 | Professional | None | $489.78 | $602.56 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $912.01 Typical High $1,230.27 | Professional | 50 · Both sides | $741.31 | $912.01 | $1,230.27 |
BCBS Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $776.25 | Professional | None | $489.78 | $602.56 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,187.76 | Facility | None | $602.56 | $1,122.02 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $1,047.13 | Professional | None | $416.87 | $588.84 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,584.89 Typical High $16,218.10 | Facility | None | $562.34 | $1,584.89 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $3,715.35 Typical High $4,073.80 | Professional | None | $602.56 | $3,715.35 | $4,073.80 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,047.13 | Professional | None | $467.74 | $645.65 | $1,047.13 |
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 $208.93 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $208.93 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $85.11 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $316.23 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $63.10 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $295.12 | $354.81 | $416.87 |
Where Missouri sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.