How much rates vary
Facilitymedian $2,291 · 10th to 90th $537 to $8,710Professionalmedian $513 · 10th to 90th $363 to $1,318
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 $851.14 Median $3,162.28 Typical High $7,762.47 | Facility | None | $851.14 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $954.99 | Professional | None | $371.54 | $426.58 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $363.08 Median $549.54 Typical High $741.31 | Professional | None | $363.08 | $549.54 | $741.31 |
BCBS Kansas City Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $524.81 | Professional | None | $346.74 | $371.54 | $524.81 |
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 $363.08 Median $416.87 Typical High $831.76 | Professional | None | $363.08 | $416.87 | $831.76 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $4,073.80 Typical High $12,022.64 | Facility | None | $794.33 | $4,073.80 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $933.25 Typical High $3,388.44 | Professional | None | $407.38 | $933.25 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $1,023.29 | Professional | None | $371.54 | $524.81 | $1,023.29 |
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 $186.21 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $186.21 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $91.20 | Professional | 53 · Discontinued | $74.13 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | 54 · Surgery only | $281.84 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $295.12 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $263.03 | $295.12 | $323.59 |
Where Missouri sits
The same service costs 5.9 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 $6,847MT $1,164
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.