How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,096 to $9,333Professionalmedian $479 · 10th to 90th $331 to $1,380
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 $588.84 Median $4,677.35 Typical High $7,762.47 | Facility | None | $588.84 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $851.14 | Professional | None | $331.13 | $380.19 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $467.74 Typical High $467.74 | Professional | None | $141.25 | $467.74 | $467.74 |
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 $363.08 Median $524.81 Typical High $707.95 | Professional | None | $363.08 | $524.81 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $794.33 Typical High $1,047.13 | Professional | 50 · Both sides | $537.03 | $794.33 | $1,047.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $478.63 | Professional | None | $309.03 | $338.84 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $2,691.53 | Facility | None | $645.65 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $758.58 | Professional | None | $331.13 | $371.54 | $758.58 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $3,715.35 Typical High $26,302.68 | Facility | None | $630.96 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $831.76 Typical High $2,951.21 | Professional | None | $363.08 | $831.76 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $912.01 | Professional | None | $338.84 | $467.74 | $912.01 |
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 $165.96 Median $190.55 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $288.40 |
Where Missouri sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.