How much rates vary
Facilitymedian $912 · 10th to 90th $115 to $5,370Professionalmedian $372 · 10th to 90th $295 to $2,399
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 $389.05 Median $3,162.28 Typical High $7,762.47 | Facility | None | $389.05 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $398.11 | Professional | None | $331.13 | $371.54 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $524.81 | Professional | None | $302.00 | $371.54 | $524.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $549.54 Typical High $794.33 | Professional | 50 · Both sides | $457.09 | $549.54 | $794.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $426.58 | Professional | None | $295.12 | $331.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $181.97 Typical High $257.04 | Facility | None | $58.88 | $181.97 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $562.34 | Professional | None | $295.12 | $323.59 | $562.34 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $380.19 Typical High $1,380.38 | Facility | None | $54.95 | $380.19 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $2,398.83 Typical High $2,454.71 | Professional | None | $302.00 | $2,398.83 | $2,454.71 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $588.84 | Professional | None | $288.40 | $363.08 | $588.84 |
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 $165.96 Median $181.97 Typical High $194.98 | Professional | 52 · Reduced service | $165.96 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $66.07 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $275.42 |
Where Missouri sits
The same service costs 7.4 times more in Hawaii than in Florida. 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
HI $3,255FL $440
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.