How much rates vary
Facilitymedian $1,862 · 10th to 90th $479 to $5,754Professionalmedian $295 · 10th to 90th $178 to $1,349
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 $363.08 Median $3,715.35 Typical High $6,309.57 | Facility | None | $363.08 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $407.38 | Professional | None | $186.21 | $323.59 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $323.59 | Professional | None | $177.83 | $239.88 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $363.08 Typical High $478.63 | Professional | 50 · Both sides | $269.15 | $363.08 | $478.63 |
BCBS Kansas City Setting Professional Modifier None Typical Low $158.49 Median $316.23 Typical High $363.08 | Professional | None | $158.49 | $316.23 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $2,187.76 | Facility | None | $602.56 | $1,380.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $457.09 | Professional | None | $177.83 | $295.12 | $457.09 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $2,344.23 Typical High $16,218.10 | Facility | None | $380.19 | $2,344.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $1,348.96 Typical High $2,454.71 | Professional | None | $302.00 | $1,348.96 | $2,454.71 |
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 $169.82 Median $295.12 Typical High $537.03 | Professional | None | $169.82 | $295.12 | $537.03 |
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 $93.33 Median $141.25 Typical High $199.53 | Professional | 52 · Reduced service | $93.33 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $56.23 Typical High $79.43 | Professional | 53 · Discontinued | $37.15 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $208.93 Typical High $302.00 | Professional | 54 · Surgery only | $141.25 | $208.93 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $41.69 Typical High $60.26 | Professional | 55 · Aftercare only | $28.18 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.18 Typical High $39.81 | Professional | 56 · Pre-op care only | $18.62 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $194.98 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $131.83 | $194.98 | $281.84 |
Where Missouri sits
The same service costs 6.3 times more in Colorado 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
CO $4,654MT $736
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.