How much rates vary
Facilitymedian $2,042 · 10th to 90th $562 to $6,310Professionalmedian $525 · 10th to 90th $389 to $1,202
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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $1,548.82 | Professional | None | $389.05 | $426.58 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $758.58 | Professional | None | $389.05 | $501.19 | $758.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $602.56 | Professional | None | $398.11 | $436.52 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,187.76 | Facility | None | $602.56 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $954.99 | Professional | None | $389.05 | $512.86 | $954.99 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $16,218.10 | Facility | None | $724.44 | $2,754.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $3,162.28 | Professional | None | $501.19 | $870.96 | $3,162.28 |
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 $446.68 Median $616.60 Typical High $912.01 | Professional | None | $446.68 | $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 $194.98 Median $208.93 Typical High $234.42 | Professional | 52 · Reduced service | $194.98 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $93.33 | Professional | 53 · Discontinued | $77.62 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $346.74 | Professional | 54 · Surgery only | $295.12 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $323.59 |
Where Missouri sits
The same service costs 4.1 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 $5,653MT $1,368
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.