How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,230 to $12,023Professionalmedian $891 · 10th to 90th $479 to $1,862
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 $707.95 Median $7,585.78 Typical High $19,952.62 | Facility | None | $707.95 | $7,585.78 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,202.26 | Professional | None | $478.63 | $707.95 | $1,202.26 |
BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $22,908.68 | Facility | None | $8,511.38 | $11,220.18 | $22,908.68 |
BCBS Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $1,023.29 | Professional | None | $416.87 | $741.31 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,454.71 Typical High $6,456.54 | Facility | None | $1,288.25 | $2,454.71 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,862.09 | Professional | None | $851.14 | $1,258.93 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $12,022.64 | Facility | None | $891.25 | $1,819.70 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,819.70 Typical High $5,754.40 | Professional | None | $776.25 | $1,819.70 | $5,754.40 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,479.11 | $2,089.30 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $6,760.83 | Facility | None | $1,288.25 | $4,168.69 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,454.71 | Professional | None | $891.25 | $1,621.81 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $8,128.31 | Facility | None | $1,174.90 | $1,862.09 | $8,128.31 |
United Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,778.28 | Professional | None | $562.34 | $1,000.00 | $1,778.28 |
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 $239.88 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $239.88 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $141.25 Typical High $162.18 | Professional | 53 · Discontinued | $95.50 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $354.81 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $72.44 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $70.79 Typical High $81.28 | Professional | 56 · Pre-op care only | $47.86 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $331.13 | $501.19 | $562.34 |
Where Nebraska sits
The same service costs 5.1 times more in Alaska 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
AK $9,382MT $1,832
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.