How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,000 to $7,079Professionalmedian $617 · 10th to 90th $457 to $3,548
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 $758.58 Median $3,715.35 Typical High $7,762.47 | Facility | None | $758.58 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $776.25 | Professional | None | $489.78 | $660.69 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,288.25 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $794.33 | Professional | None | $446.68 | $537.03 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $812.83 Typical High $1,174.90 | Professional | 50 · Both sides | $676.08 | $812.83 | $1,174.90 |
BCBS Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $707.95 | Professional | None | $416.87 | $630.96 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $2,187.76 | Facility | None | $602.56 | $1,621.81 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $977.24 | Professional | None | $436.52 | $616.60 | $977.24 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $16,218.10 | Facility | None | $724.44 | $2,754.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $3,548.13 Typical High $4,786.30 | Professional | None | $588.84 | $3,548.13 | $4,786.30 |
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 $436.52 Median $630.96 Typical High $1,071.52 | Professional | None | $436.52 | $630.96 | $1,071.52 |
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 $245.47 Median $316.23 Typical High $380.19 | Professional | 52 · Reduced service | $245.47 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $97.72 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $363.08 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $95.50 Typical High $114.82 | Professional | 55 · Aftercare only | $72.44 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $48.98 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $446.68 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $338.84 | $446.68 | $537.03 |
Where Missouri sits
The same service costs 3.1 times more in Alaska 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
AK $5,141MT $1,633
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.