How much rates vary
Facilitymedian $2,344 · 10th to 90th $603 to $6,310Professionalmedian $708 · 10th to 90th $200 to $2,291
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 $870.96 Median $4,677.35 Typical High $7,762.47 | Facility | None | $870.96 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $812.83 Typical High $1,479.11 | Professional | None | $190.55 | $812.83 | $1,479.11 |
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 $204.17 Median $354.81 Typical High $1,174.90 | Professional | None | $204.17 | $354.81 | $1,174.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $169.82 Median $741.31 Typical High $977.24 | Professional | None | $169.82 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,570.40 Typical High $3,715.35 | Facility | None | $602.56 | $2,570.40 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $457.09 Typical High $1,513.56 | Professional | None | $177.83 | $457.09 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $16,218.10 | Facility | None | $758.58 | $2,884.03 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $2,818.38 Typical High $5,623.41 | Professional | None | $1,047.13 | $2,818.38 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,000.00 | $3,467.37 | $6,760.83 |
United Setting Professional Modifier None Typical Low $263.03 Median $758.58 Typical High $1,819.70 | Professional | None | $263.03 | $758.58 | $1,819.70 |
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 $95.50 Median $154.88 Typical High $467.74 | Professional | 52 · Reduced service | $95.50 | $154.88 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $63.10 Typical High $186.21 | Professional | 53 · Discontinued | $38.02 | $63.10 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $234.42 Typical High $707.95 | Professional | 54 · Surgery only | $141.25 | $234.42 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $46.77 Typical High $141.25 | Professional | 55 · Aftercare only | $28.84 | $46.77 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $30.90 Typical High $93.33 | Professional | 56 · Pre-op care only | $19.05 | $30.90 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $218.78 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $131.83 | $218.78 | $660.69 |
Where Missouri sits
The same service costs 5.1 times more in Colorado 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
CO $7,315MT $1,443
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.