How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,072 to $11,749Professionalmedian $1,259 · 10th to 90th $182 to $1,862
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 $1,737.80 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,737.80 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,698.24 | $1,737.80 | $1,737.80 |
BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,202.26 | $3,162.28 | $9,332.54 |
BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,318.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $3,090.30 | Facility | None | $630.96 | $1,905.46 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,288.25 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,174.90 Typical High $2,398.83 | Facility | None | $891.25 | $1,174.90 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,584.89 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $954.99 Typical High $1,862.09 | Professional | None | $158.49 | $954.99 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,445.44 | $2,511.89 |
8 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 $851.14 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $851.14 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $169.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,398.83 Typical High $2,951.21 | Professional | 50 · Both sides | $1,862.09 | $2,398.83 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $812.83 Typical High $977.24 | Professional | 51 · Multiple procedures | $616.60 | $812.83 | $977.24 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Delaware. 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 $9,962DE $3,108
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.