How much rates vary
Facilitymedian $9,333 · 10th to 90th $1,479 to $47,863Professionalmedian $1,445 · 10th to 90th $933 to $3,981
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 $1,174.90 Median $6,309.57 Typical High $47,863.01 | Facility | None | $1,174.90 | $6,309.57 | $47,863.01 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $4,365.16 | Professional | None | $954.99 | $1,096.48 | $4,365.16 |
Ambetter Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,288.25 | Professional | None | $741.31 | $1,202.26 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $7,079.46 Typical High $26,915.35 | Facility | None | $1,445.44 | $7,079.46 | $26,915.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $1,905.46 | Professional | None | $977.24 | $1,445.44 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $912.01 Typical High $1,174.90 | Professional | 62 · Two surgeons | $616.60 | $912.01 | $1,174.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,174.90 | Professional | None | $812.83 | $870.96 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $28,183.83 Typical High $44,668.36 | Facility | None | $1,096.48 | $28,183.83 | $44,668.36 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $2,630.27 | Professional | None | $851.14 | $1,148.15 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $12,882.50 Typical High $141,253.75 | Facility | None | $1,479.11 | $12,882.50 | $141,253.75 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $2,398.83 Typical High $26,302.68 | Professional | None | $1,230.27 | $2,398.83 | $26,302.68 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $10,715.19 Typical High $53,703.18 | Facility | None | $1,584.89 | $10,715.19 | $53,703.18 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,023.29 | $1,584.89 | $2,754.23 |
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 $478.63 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $190.55 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $95.50 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $776.25 | $812.83 |
Where Missouri sits
The same service costs 19.9 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 $53,750MT $2,699
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.