How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,000 to $8,511Professionalmedian $447 · 10th to 90th $324 to $2,455
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 $501.19 Median $3,715.35 Typical High $7,762.47 | Facility | None | $501.19 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $537.03 | Professional | None | $275.42 | $371.54 | $537.03 |
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 $309.03 Median $380.19 Typical High $537.03 | Professional | None | $309.03 | $380.19 | $537.03 |
BCBS Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $616.60 | Professional | None | $316.23 | $489.78 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,344.23 | Facility | None | $602.56 | $1,995.26 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $758.58 | Professional | None | $275.42 | $467.74 | $758.58 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $2,344.23 Typical High $16,218.10 | Facility | None | $616.60 | $2,344.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $2,454.71 Typical High $3,630.78 | Professional | None | $524.81 | $2,454.71 | $3,630.78 |
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 $331.13 Median $501.19 Typical High $776.25 | Professional | None | $331.13 | $501.19 | $776.25 |
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 $138.04 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $138.04 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $81.28 Typical High $100.00 | Professional | 53 · Discontinued | $54.95 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $302.00 Typical High $380.19 | Professional | 54 · Surgery only | $208.93 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $41.69 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $27.54 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $281.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $194.98 | $281.84 | $354.81 |
Where Missouri sits
The same service costs 5.3 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 $6,378MT $1,213
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.