How much rates vary
Facilitymedian $1,413 · 10th to 90th $123 to $5,623Professionalmedian $141 · 10th to 90th $100 to $741
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 $117.49 Median $3,162.28 Typical High $6,309.57 | Facility | None | $117.49 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $141.25 | Professional | None | $95.50 | $109.65 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $104.71 Median $131.83 Typical High $190.55 | Professional | None | $104.71 | $131.83 | $190.55 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $66.07 Median $83.18 Typical High $120.23 | Professional | 62 · Two surgeons | $66.07 | $83.18 | $120.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $144.54 | Professional | None | $95.50 | $104.71 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $2,691.53 | Facility | None | $1,096.48 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $208.93 | Professional | None | $97.72 | $114.82 | $208.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $251.19 Typical High $1,288.25 | Facility | None | $54.95 | $251.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $741.31 Typical High $741.31 | Professional | None | $125.89 | $741.31 | $741.31 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $251.19 | Professional | None | $97.72 | $144.54 | $251.19 |
5 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 $47.86 Median $50.12 Typical High $57.54 | Professional | 52 · Reduced service | $47.86 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $19.05 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $75.86 Typical High $87.10 | Professional | 54 · Surgery only | $70.79 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.14 Typical High $17.38 | Professional | 55 · Aftercare only | $14.13 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.00 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.55 | $10.00 | $11.48 |
Where Missouri sits
The same service costs 13.9 times more in Utah than in Delaware. 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
UT $3,071DE $220
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.