How much rates vary
Facilitymedian $4,467 · 10th to 90th $955 to $10,471Professionalmedian $6,310 · 10th to 90th $457 to $21,380
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 $2,511.89 Median $5,623.41 Typical High $11,748.98 | Facility | None | $2,511.89 | $5,623.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $5,128.61 Typical High $6,309.57 | Professional | None | $407.38 | $5,128.61 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $1,819.70 Typical High $8,317.64 | Professional | None | $478.63 | $1,819.70 | $8,317.64 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $5,370.32 Typical High $7,943.28 | Professional | None | $426.58 | $5,370.32 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $7,585.78 Typical High $10,964.78 | Facility | None | $707.95 | $7,585.78 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $1,122.02 Typical High $10,232.93 | Professional | None | $426.58 | $1,122.02 | $10,232.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $4,365.16 Typical High $13,489.63 | Facility | None | $54.95 | $4,365.16 | $13,489.63 |
Medica Setting Professional Modifier None Typical Low $8,912.51 Median $21,379.62 Typical High $42,657.95 | Professional | None | $8,912.51 | $21,379.62 | $42,657.95 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $524.81 Median $5,248.07 Typical High $12,882.50 | Professional | None | $524.81 | $5,248.07 | $12,882.50 |
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 $204.17 Median $2,570.40 Typical High $3,162.28 | Professional | 52 · Reduced service | $204.17 | $2,570.40 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $1,023.29 Typical High $1,258.93 | Professional | 53 · Discontinued | $81.28 | $1,023.29 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $3,890.45 Typical High $4,786.30 | Professional | 54 · Surgery only | $309.03 | $3,890.45 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $776.25 Typical High $954.99 | Professional | 55 · Aftercare only | $61.66 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $512.86 Typical High $630.96 | Professional | 56 · Pre-op care only | $40.74 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $3,630.78 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $288.40 | $3,630.78 | $4,466.84 |
Where Missouri sits
The same service costs 4.1 times more in Iowa 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
IA $18,453DE $4,539
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.