How much rates vary
Facilitymedian $2,042 · 10th to 90th $631 to $5,623Professionalmedian $912 · 10th to 90th $676 to $2,512
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,174.90 | Professional | None | $602.56 | $724.44 | $1,174.90 |
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 $724.44 Median $851.14 Typical High $1,230.27 | Professional | None | $724.44 | $851.14 | $1,230.27 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $954.99 | Professional | None | $676.08 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,230.27 Typical High $2,691.53 | Facility | None | $645.65 | $1,230.27 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,412.54 | Professional | None | $602.56 | $794.33 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $26,302.68 | Facility | None | $954.99 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,348.96 Typical High $5,370.32 | Professional | None | $758.58 | $1,348.96 | $5,370.32 |
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 $660.69 Median $1,148.15 Typical High $1,513.56 | Professional | None | $660.69 | $1,148.15 | $1,513.56 |
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 $302.00 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $524.81 |
Where Missouri sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.