How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $6,310Professionalmedian $302 · 10th to 90th $219 to $776
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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $602.56 | Professional | None | $213.80 | $245.47 | $602.56 |
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 $234.42 Median $302.00 Typical High $446.68 | Professional | None | $234.42 | $302.00 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $457.09 Typical High $676.08 | Professional | 50 · Both sides | $346.74 | $457.09 | $676.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $302.00 | Professional | None | $194.98 | $213.80 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,698.24 Typical High $2,511.89 | Facility | None | $446.68 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $478.63 | Professional | None | $208.93 | $257.04 | $478.63 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $2,754.23 Typical High $12,022.64 | Facility | None | $602.56 | $2,754.23 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $537.03 Typical High $1,778.28 | Professional | None | $234.42 | $537.03 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $588.84 | Professional | None | $218.78 | $302.00 | $588.84 |
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 $107.15 Median $120.23 Typical High $131.83 | Professional | 52 · Reduced service | $107.15 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $47.86 Typical High $52.48 | Professional | 53 · Discontinued | $42.66 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $199.53 | Professional | 54 · Surgery only | $158.49 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $39.81 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $23.99 Typical High $26.30 | Professional | 56 · Pre-op care only | $21.38 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $169.82 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $147.91 | $169.82 | $186.21 |
Where Missouri sits
The same service costs 9.6 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 $6,197MT $647
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.