How much rates vary
Facilitymedian $1,660 · 10th to 90th $479 to $5,623Professionalmedian $363 · 10th to 90th $204 to $1,660
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 $213.80 Median $1,819.70 Typical High $6,309.57 | Facility | None | $213.80 | $1,819.70 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $363.08 Typical High $575.44 | Professional | None | $158.49 | $363.08 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $263.03 | Professional | None | $154.88 | $229.09 | $263.03 |
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 $204.17 Median $239.88 Typical High $354.81 | Professional | None | $204.17 | $239.88 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $363.08 Typical High $524.81 | Professional | 50 · Both sides | $309.03 | $363.08 | $524.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $177.83 Median $436.52 Typical High $549.54 | Professional | None | $177.83 | $436.52 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,202.26 Typical High $1,659.59 | Facility | None | $630.96 | $1,202.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $660.69 | Professional | None | $199.53 | $363.08 | $660.69 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $2,290.87 Typical High $39,810.72 | Facility | None | $630.96 | $2,290.87 | $39,810.72 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,659.59 Typical High $3,235.94 | Professional | None | $489.78 | $1,659.59 | $3,235.94 |
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 $229.09 Median $398.11 Typical High $758.58 | Professional | None | $229.09 | $398.11 | $758.58 |
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 $79.43 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $79.43 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $72.44 Typical High $89.13 | Professional | 53 · Discontinued | $31.62 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $269.15 Typical High $331.13 | Professional | 54 · Surgery only | $117.49 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $54.95 Typical High $66.07 | Professional | 55 · Aftercare only | $23.99 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $15.85 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $251.19 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $109.65 | $251.19 | $309.03 |
Where Missouri sits
The same service costs 4.6 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 $4,728MT $1,029
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.