How much rates vary
Facilitymedian $1,820 · 10th to 90th $562 to $5,623Professionalmedian $575 · 10th to 90th $363 to $3,631
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 $660.69 Median $3,162.28 Typical High $6,309.57 | Facility | None | $660.69 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $537.03 Typical High $870.96 | Professional | None | $295.12 | $537.03 | $870.96 |
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 $354.81 Median $416.87 Typical High $602.56 | Professional | None | $354.81 | $416.87 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $616.60 Typical High $891.25 | Professional | 50 · Both sides | $524.81 | $616.60 | $891.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $436.52 Median $933.25 Typical High $1,318.26 | Professional | None | $436.52 | $933.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,202.26 Typical High $1,659.59 | Facility | None | $446.68 | $1,202.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $602.56 Typical High $1,096.48 | Professional | None | $354.81 | $602.56 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $2,398.83 Typical High $12,022.64 | Facility | None | $776.25 | $2,398.83 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $3,630.78 Typical High $6,606.93 | Professional | None | $724.44 | $3,630.78 | $6,606.93 |
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 $380.19 Median $630.96 Typical High $1,096.48 | Professional | None | $380.19 | $630.96 | $1,096.48 |
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 $147.91 Median $269.15 Typical High $436.52 | Professional | 52 · Reduced service | $147.91 | $269.15 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $107.15 Typical High $173.78 | Professional | 53 · Discontinued | $58.88 | $107.15 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $407.38 Typical High $645.65 | Professional | 54 · Surgery only | $218.78 | $407.38 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $81.28 Typical High $128.82 | Professional | 55 · Aftercare only | $43.65 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $53.70 Typical High $87.10 | Professional | 56 · Pre-op care only | $29.51 | $53.70 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $380.19 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $204.17 | $380.19 | $602.56 |
Where Missouri sits
The same service costs 3.2 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 $4,968MT $1,567
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.