How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,175 to $14,454Professionalmedian $891 · 10th to 90th $646 to $3,548
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 $724.44 Median $4,897.79 Typical High $9,549.93 | Facility | None | $724.44 | $4,897.79 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,445.44 | Professional | None | $588.84 | $691.83 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $977.24 | Professional | None | $426.58 | $645.65 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $5,888.44 Typical High $16,982.44 | Facility | None | $1,513.56 | $5,888.44 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,380.38 | Professional | None | $724.44 | $933.25 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,412.54 Typical High $2,089.30 | Professional | 50 · Both sides | $1,096.48 | $1,412.54 | $2,089.30 |
BCBS Kansas City Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $912.01 | Professional | None | $645.65 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,290.87 Typical High $10,471.29 | Facility | None | $1,412.54 | $2,290.87 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,412.54 | Professional | None | $575.44 | $758.58 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $4,168.69 Typical High $33,884.42 | Facility | None | $891.25 | $4,168.69 | $33,884.42 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,202.26 Typical High $5,754.40 | Professional | None | $691.83 | $1,202.26 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,981.07 Typical High $9,120.11 | Facility | None | $1,096.48 | $3,981.07 | $9,120.11 |
United Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,380.38 | Professional | None | $616.60 | $891.25 | $1,380.38 |
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 $295.12 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $436.52 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $87.10 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $537.03 |
Where Missouri sits
The same service costs 3.6 times more in Wisconsin 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
WI $7,904MT $2,218
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.