How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,000 to $8,913Professionalmedian $537 · 10th to 90th $316 to $3,090
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 $588.84 Median $4,677.35 Typical High $7,762.47 | Facility | None | $588.84 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $630.96 | Professional | None | $338.84 | $426.58 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,585.78 | Facility | None | $1,318.26 | $3,467.37 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $630.96 | Professional | None | $309.03 | $416.87 | $630.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $707.95 | Professional | None | $389.05 | $575.44 | $707.95 |
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 $338.84 Median $575.44 Typical High $933.25 | Professional | None | $338.84 | $575.44 | $933.25 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $2,344.23 Typical High $26,302.68 | Facility | None | $707.95 | $2,344.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $3,090.30 Typical High $4,265.80 | Professional | None | $602.56 | $3,090.30 | $4,265.80 |
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 $398.11 Median $616.60 Typical High $912.01 | Professional | None | $398.11 | $616.60 | $912.01 |
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 $169.82 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $169.82 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $95.50 Typical High $117.49 | Professional | 53 · Discontinued | $69.18 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $354.81 Typical High $446.68 | Professional | 54 · Surgery only | $257.04 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $70.79 Typical High $89.13 | Professional | 55 · Aftercare only | $51.29 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $33.88 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $331.13 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $239.88 | $331.13 | $416.87 |
Where Missouri sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.