How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,318 to $10,471Professionalmedian $1,905 · 10th to 90th $1,288 to $4,365
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 $1,584.89 Median $5,623.41 Typical High $8,709.64 | Facility | None | $1,584.89 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,380.38 | $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 $1,318.26 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,819.70 | $2,754.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $4,365.16 | Facility | None | $912.01 | $3,630.78 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,584.89 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $4,073.80 Typical High $26,302.68 | Facility | None | $1,348.96 | $4,073.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $8,912.51 Typical High $10,964.78 | Professional | None | $1,862.09 | $8,912.51 | $10,964.78 |
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 $1,445.44 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,445.44 | $2,187.76 | $3,548.13 |
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 $562.34 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $562.34 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $165.96 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $1,122.02 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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 $12,311KY $3,892
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.