How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,288 to $33,884Professionalmedian $537 · 10th to 90th $363 to $1,950
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 $1,148.15 Median $4,677.35 Typical High $18,620.87 | Facility | None | $1,148.15 | $4,677.35 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $851.14 | Professional | None | $323.59 | $389.05 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,801.89 Typical High $19,952.62 | Facility | None | $1,380.38 | $3,801.89 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $691.83 | Professional | None | $407.38 | $537.03 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $338.84 Typical High $436.52 | Professional | 62 · Two surgeons | $257.04 | $338.84 | $436.52 |
BCBS Kansas City Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $537.03 | Professional | None | $371.54 | $398.11 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $16,595.87 Typical High $27,542.29 | Facility | None | $707.95 | $16,595.87 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $776.25 | Professional | None | $323.59 | $426.58 | $776.25 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $8,511.38 Typical High $83,176.38 | Facility | None | $1,096.48 | $8,511.38 | $83,176.38 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $776.25 Typical High $8,511.38 | Professional | None | $407.38 | $776.25 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,413.10 Typical High $33,884.42 | Facility | None | $1,479.11 | $7,413.10 | $33,884.42 |
United Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $812.83 | Professional | None | $346.74 | $602.56 | $812.83 |
7 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 $190.55 Typical High $199.53 | Professional | 52 · Reduced service | $162.18 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $75.86 Typical High $79.43 | Professional | 53 · Discontinued | $64.57 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $295.12 | Professional | 54 · Surgery only | $239.88 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $57.54 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $32.36 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $269.15 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $223.87 | $269.15 | $275.42 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Where Missouri sits
The same service costs 29.4 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 $37,066MT $1,262
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.