How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,230 to $10,715Professionalmedian $1,000 · 10th to 90th $759 to $2,239
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,778.28 | Professional | None | $741.31 | $794.33 | $1,778.28 |
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 $776.25 Median $1,000.00 Typical High $1,380.38 | Professional | None | $776.25 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $630.96 Typical High $870.96 | Professional | 62 · Two surgeons | $489.78 | $630.96 | $870.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,096.48 | Professional | None | $724.44 | $794.33 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,951.21 Typical High $4,365.16 | Facility | None | $645.65 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,778.28 | Professional | None | $741.31 | $891.25 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,000.00 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $5,888.44 | Professional | None | $851.14 | $1,584.89 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,737.80 | Professional | None | $812.83 | $1,122.02 | $1,737.80 |
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 $371.54 Median $398.11 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $575.44 |
Where Missouri sits
The same service costs 4.2 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 $10,315MT $2,461
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.