How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,072 to $10,471Professionalmedian $912 · 10th to 90th $708 to $6,166
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 $977.24 Median $3,162.28 Typical High $7,762.47 | Facility | None | $977.24 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,230.27 | Professional | None | $851.14 | $912.01 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $933.25 | Professional | None | $660.69 | $660.69 | $933.25 |
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 $741.31 Median $891.25 Typical High $1,288.25 | Professional | None | $741.31 | $891.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,348.96 Typical High $1,949.84 | Professional | 50 · Both sides | $1,096.48 | $1,348.96 | $1,949.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,000.00 | Professional | None | $707.95 | $758.58 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $3,162.28 | Facility | None | $478.63 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,380.38 | Professional | None | $741.31 | $794.33 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $2,754.23 Typical High $12,022.64 | Facility | None | $933.25 | $2,754.23 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,380.38 Typical High $6,165.95 | Professional | None | $645.65 | $1,380.38 | $6,165.95 |
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 $645.65 Median $851.14 Typical High $1,479.11 | Professional | None | $645.65 | $851.14 | $1,479.11 |
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 $426.58 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $630.96 | $691.83 |
Where Missouri sits
The same service costs 5.4 times more in Alaska than in South Carolina. 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 $8,807SC $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.