How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,148 to $8,913Professionalmedian $1,148 · 10th to 90th $851 to $7,762
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 $1,071.52 Median $1,148.15 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,148.15 | $1,949.84 |
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 $891.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $891.25 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,454.71 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $707.95 Typical High $1,023.29 | Professional | 62 · Two surgeons | $562.34 | $707.95 | $1,023.29 |
BCBS Kansas City Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,258.93 | Professional | None | $891.25 | $954.99 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $2,691.53 | Facility | None | $645.65 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,737.80 | Professional | None | $933.25 | $1,000.00 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,801.89 Typical High $26,302.68 | Facility | None | $1,071.52 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,737.80 Typical High $7,762.47 | Professional | None | $851.14 | $1,737.80 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,862.09 | Professional | None | $851.14 | $1,047.13 | $1,862.09 |
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 $537.03 Median $575.44 Typical High $630.96 | Professional | 52 · Reduced service | $537.03 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $870.96 |
Where Missouri sits
The same service costs 3.4 times more in Alaska than in West Virginia. 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 $8,636WV $2,535
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.