How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $18,197Professionalmedian $501 · 10th to 90th $191 to $14,454
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 $1,174.90 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,174.90 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $1,698.24 Typical High $3,548.13 | Professional | None | $323.59 | $1,698.24 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,715.35 Typical High $16,982.44 | Facility | None | $1,318.26 | $3,715.35 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $537.03 | Professional | None | $181.97 | $331.13 | $537.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $446.68 Median $851.14 Typical High $5,754.40 | Professional | None | $446.68 | $851.14 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $10,715.19 Typical High $19,498.45 | Facility | None | $478.63 | $10,715.19 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $524.81 Typical High $4,168.69 | Professional | None | $245.47 | $524.81 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $5,011.87 Typical High $42,657.95 | Facility | None | $489.78 | $5,011.87 | $42,657.95 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $14,454.40 Typical High $28,183.83 | Professional | None | $338.84 | $14,454.40 | $28,183.83 |
United Setting Facility Modifier None Typical Low $977.24 Median $5,011.87 Typical High $16,218.10 | Facility | None | $977.24 | $5,011.87 | $16,218.10 |
United Setting Professional Modifier None Typical Low $257.04 Median $602.56 Typical High $3,801.89 | Professional | None | $257.04 | $602.56 | $3,801.89 |
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 $354.81 Typical High $1,778.28 | Professional | 52 · Reduced service | $162.18 | $354.81 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $141.25 Typical High $707.95 | Professional | 53 · Discontinued | $64.57 | $141.25 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $524.81 Typical High $2,691.53 | Professional | 54 · Surgery only | $245.47 | $524.81 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $104.71 Typical High $537.03 | Professional | 55 · Aftercare only | $48.98 | $104.71 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $70.79 Typical High $354.81 | Professional | 56 · Pre-op care only | $32.36 | $70.79 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $489.78 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $229.09 | $489.78 | $2,511.89 |
Where Missouri sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.