How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,413 to $23,988Professionalmedian $832 · 10th to 90th $631 to $1,778
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 $2,398.83 Median $6,309.57 Typical High $20,417.38 | Facility | None | $2,398.83 | $6,309.57 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $4,897.79 | Professional | None | $630.96 | $794.33 | $4,897.79 |
Ambetter Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $13,489.63 Typical High $20,892.96 | Facility | None | $8,128.31 | $13,489.63 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,230.27 | Professional | None | $630.96 | $741.31 | $1,230.27 |
BCBS Kansas City Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $933.25 | Professional | None | $645.65 | $707.95 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $11,481.54 Typical High $27,542.29 | Facility | None | $7,413.10 | $11,481.54 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,479.11 | Professional | None | $645.65 | $912.01 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $4,365.16 Typical High $31,622.78 | Facility | None | $954.99 | $4,365.16 | $31,622.78 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,479.11 Typical High $3,981.07 | Professional | None | $891.25 | $1,479.11 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $7,762.47 Typical High $26,915.35 | Facility | None | $1,174.90 | $7,762.47 | $26,915.35 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,230.27 Typical High $1,778.28 | Professional | None | $691.83 | $1,230.27 | $1,778.28 |
5 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 $323.59 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $323.59 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $602.56 | Professional | 54 · Surgery only | $478.63 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $79.43 |
Where Missouri sits
The same service costs 9.6 times more in Oklahoma 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
OK $19,472MT $2,030
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.