How much rates vary
Facilitymedian $1,778 · 10th to 90th $479 to $5,623Professionalmedian $363 · 10th to 90th $195 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 $1,698.24 Typical High $6,309.57 | Facility | None | $213.80 | $1,698.24 | $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 $436.52 | Professional | None | $154.88 | $229.09 | $436.52 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $346.74 Typical High $645.65 | Professional | 50 · Both sides | $229.09 | $346.74 | $645.65 |
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 $346.74 | Professional | None | $204.17 | $239.88 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $354.81 Typical High $524.81 | Professional | 50 · Both sides | $302.00 | $354.81 | $524.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $177.83 Median $446.68 Typical High $562.34 | Professional | None | $177.83 | $446.68 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,230.27 Typical High $3,801.89 | Facility | None | $831.76 | $1,230.27 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $660.69 | Professional | None | $194.98 | $363.08 | $660.69 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $2,290.87 Typical High $39,810.72 | Facility | None | $616.60 | $2,290.87 | $39,810.72 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,659.59 Typical High $3,311.31 | Professional | None | $478.63 | $1,659.59 | $3,311.31 |
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 $120.23 Median $275.42 Typical High $338.84 | Professional | 54 · Surgery only | $120.23 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $54.95 Typical High $67.61 | Professional | 55 · Aftercare only | $23.99 | $54.95 | $67.61 |
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 $112.20 Median $257.04 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $112.20 | $257.04 | $316.23 |
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 $4,720MT $1,020
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.