How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,000 to $7,762Professionalmedian $468 · 10th to 90th $331 to $1,514
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 $1,548.82 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,548.82 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $741.31 | Professional | None | $331.13 | $380.19 | $741.31 |
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 $354.81 Median $549.54 Typical High $691.83 | Professional | None | $354.81 | $549.54 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $724.44 Typical High $1,000.00 | Professional | 50 · Both sides | $524.81 | $724.44 | $1,000.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $467.74 | Professional | None | $302.00 | $331.13 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $3,311.31 | Facility | None | $758.58 | $1,318.26 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $741.31 | Professional | None | $323.59 | $363.08 | $741.31 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $26,302.68 | Facility | None | $645.65 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $831.76 Typical High $3,235.94 | Professional | None | $363.08 | $831.76 | $3,235.94 |
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 $331.13 Median $467.74 Typical High $912.01 | Professional | None | $331.13 | $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 $162.18 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $162.18 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $66.07 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | 54 · Surgery only | $245.47 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $60.26 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $281.84 |
Where Missouri sits
The same service costs 5.1 times more in Oklahoma 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
OK $5,094MT $991
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.