How much rates vary
Facilitymedian $2,042 · 10th to 90th $513 to $6,310Professionalmedian $407 · 10th to 90th $257 to $1,995
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 $416.87 Median $4,677.35 Typical High $7,762.47 | Facility | None | $416.87 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $436.52 | Professional | None | $223.87 | $309.03 | $436.52 |
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 $251.19 Median $323.59 Typical High $446.68 | Professional | None | $251.19 | $323.59 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $489.78 | Professional | None | $257.04 | $389.05 | $489.78 |
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 $223.87 Median $380.19 Typical High $630.96 | Professional | None | $223.87 | $380.19 | $630.96 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $2,344.23 Typical High $26,302.68 | Facility | None | $512.86 | $2,344.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,995.26 Typical High $3,019.95 | Professional | None | $426.58 | $1,995.26 | $3,019.95 |
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 $269.15 Median $416.87 Typical High $660.69 | Professional | None | $269.15 | $416.87 | $660.69 |
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 $112.20 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $112.20 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $44.67 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $251.19 Typical High $316.23 | Professional | 54 · Surgery only | $165.96 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $33.11 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.88 Typical High $41.69 | Professional | 56 · Pre-op care only | $22.39 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $234.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $154.88 | $234.42 | $295.12 |
Where Missouri sits
The same service costs 6.3 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 $6,296MT $1,002
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.