How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,096 to $9,550Professionalmedian $646 · 10th to 90th $447 to $2,512
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 $549.54 Median $5,128.61 Typical High $10,715.19 | Facility | None | $549.54 | $5,128.61 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $954.99 | Professional | None | $436.52 | $501.19 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $478.63 Median $724.44 Typical High $977.24 | Professional | None | $478.63 | $724.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $1,071.52 Typical High $1,445.44 | Professional | 50 · Both sides | $724.44 | $1,071.52 | $1,445.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $616.60 | Professional | None | $398.11 | $436.52 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $3,311.31 | Facility | None | $758.58 | $2,238.72 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $1,096.48 | Professional | None | $436.52 | $537.03 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,715.35 Typical High $26,302.68 | Facility | None | $741.31 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,122.02 Typical High $6,025.60 | Professional | None | $512.86 | $1,122.02 | $6,025.60 |
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 $467.74 Median $630.96 Typical High $1,202.26 | Professional | None | $467.74 | $630.96 | $1,202.26 |
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 $218.78 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $218.78 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $87.10 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $380.19 |
Where Missouri sits
The same service costs 5.5 times more in Wisconsin 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
WI $7,406MT $1,352
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.