How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,148 to $8,710Professionalmedian $776 · 10th to 90th $646 to $2,399
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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,479.11 | Professional | None | $616.60 | $660.69 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,380.38 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,258.93 | Professional | None | $645.65 | $776.25 | $1,258.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $933.25 | Professional | None | $616.60 | $660.69 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $5,248.07 | Facility | None | $1,202.26 | $1,905.46 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,513.56 | Professional | None | $616.60 | $724.44 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $2,754.23 Typical High $26,302.68 | Facility | None | $812.83 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,318.26 Typical High $5,011.87 | Professional | None | $691.83 | $1,318.26 | $5,011.87 |
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 $660.69 Median $912.01 Typical High $1,445.44 | Professional | None | $660.69 | $912.01 | $1,445.44 |
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 $309.03 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $467.74 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $489.78 |
Where Missouri sits
The same service costs 3.2 times more in Oklahoma 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
OK $6,513MT $2,047
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.