How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,000 to $8,913Professionalmedian $550 · 10th to 90th $355 to $2,754
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 $524.81 Median $4,677.35 Typical High $7,762.47 | Facility | None | $524.81 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $602.56 | Professional | None | $302.00 | $416.87 | $602.56 |
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 $346.74 Median $436.52 Typical High $616.60 | Professional | None | $346.74 | $436.52 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $660.69 Typical High $912.01 | Professional | 50 · Both sides | $524.81 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $218.78 Median $275.42 Typical High $389.05 | Professional | 62 · Two surgeons | $218.78 | $275.42 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $691.83 | Professional | None | $354.81 | $549.54 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $5,370.32 | Facility | None | $645.65 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $851.14 | Professional | None | $302.00 | $512.86 | $851.14 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $2,344.23 Typical High $26,302.68 | Facility | None | $660.69 | $2,344.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $2,754.23 Typical High $4,073.80 | Professional | None | $588.84 | $2,754.23 | $4,073.80 |
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 $363.08 Median $562.34 Typical High $870.96 | Professional | None | $363.08 | $562.34 | $870.96 |
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 $151.36 Median $229.09 Typical High $281.84 | Professional | 52 · Reduced service | $151.36 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $60.26 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $338.84 Typical High $426.58 | Professional | 54 · Surgery only | $229.09 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $67.61 Typical High $85.11 | Professional | 55 · Aftercare only | $45.71 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $45.71 Typical High $56.23 | Professional | 56 · Pre-op care only | $30.20 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $316.23 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $213.80 | $316.23 | $398.11 |
Where Missouri sits
The same service costs 6.4 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 $8,723MT $1,361
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.