How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,318 to $11,482Professionalmedian $1,862 · 10th to 90th $1,349 to $4,571
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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,258.93 | $2,511.89 |
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 $1,348.96 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,862.09 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,818.38 Typical High $3,890.45 | Professional | 50 · Both sides | $2,041.74 | $2,818.38 | $3,890.45 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,412.54 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $5,248.07 | Facility | None | $1,202.26 | $3,801.89 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,548.82 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,479.11 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $3,019.95 Typical High $10,471.29 | Professional | None | $1,412.54 | $3,019.95 | $10,471.29 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,380.38 | $1,819.70 | $3,090.30 |
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 $616.60 Median $630.96 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,071.52 |
Where Missouri sits
The same service costs 3.1 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 $12,999DE $4,240
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.