How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $9,550Professionalmedian $1,288 · 10th to 90th $891 to $2,692
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 $1,122.02 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,122.02 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,148.15 | Professional | None | $758.58 | $912.01 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,000.00 | Facility | None | $1,412.54 | $3,801.89 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,659.59 | Professional | None | $891.25 | $1,258.93 | $1,659.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,445.44 | Professional | None | $912.01 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,995.26 | Professional | None | $933.25 | $1,023.29 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $9,772.37 | Facility | None | $54.95 | $1,230.27 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $2,041.74 Typical High $7,079.46 | Professional | None | $1,071.52 | $2,041.74 | $7,079.46 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,454.71 | Professional | None | $977.24 | $1,348.96 | $2,454.71 |
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 $380.19 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $691.83 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $645.65 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $645.65 | $660.69 |
Where Missouri sits
The same service costs 10.1 times more in Maine than in Arkansas. 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
ME $16,050AR $1,584
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.