How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,622 to $14,125Professionalmedian $380 · 10th to 90th $269 to $1,148
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 $3,162.28 Median $7,762.47 Typical High $16,595.87 | Facility | None | $3,162.28 | $7,762.47 | $16,595.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $295.12 Median $5,248.07 Typical High $12,302.69 | Professional | None (both parts) | $295.12 | $5,248.07 | $12,302.69 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $281.84 Median $288.40 Typical High $323.59 | Professional | 26 · Professional part | $281.84 | $288.40 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $16,982.44 | Facility | None | $4,570.88 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $263.03 Median $295.12 Typical High $537.03 | Professional | None (both parts) | $263.03 | $295.12 | $537.03 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $281.84 Typical High $512.86 | Professional | 26 · Professional part | $257.04 | $281.84 | $512.86 |
BCBS Kansas City Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $275.42 Typical High $371.54 | Professional | 26 · Professional part | $263.03 | $275.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $7,079.46 Median $11,220.18 Typical High $16,218.10 | Facility | None | $7,079.46 | $11,220.18 | $16,218.10 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $363.08 Typical High $602.56 | Professional | 26 · Professional part | $251.19 | $363.08 | $602.56 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $2,951.21 Typical High $8,317.64 | Facility | None | $1,000.00 | $2,951.21 | $8,317.64 |
Medica Setting Professional Modifier None (both parts) Typical Low $354.81 Median $616.60 Typical High $1,659.59 | Professional | None (both parts) | $354.81 | $616.60 | $1,659.59 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $354.81 Median $616.60 Typical High $1,659.59 | Professional | 26 · Professional part | $354.81 | $616.60 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $8,709.64 | Facility | None | $1,258.93 | $4,073.80 | $8,709.64 |
United Setting Professional Modifier None (both parts) Typical Low $281.84 Median $489.78 Typical High $707.95 | Professional | None (both parts) | $281.84 | $489.78 | $707.95 |
United Setting Professional Modifier 26 · Professional part Typical Low $281.84 Median $489.78 Typical High $707.95 | Professional | 26 · Professional part | $281.84 | $489.78 | $707.95 |
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 $141.25 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $208.93 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $32.36 |
Where Missouri sits
The same service costs 19.5 times more in Colorado than in Maryland. 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.
Missouri· 42nd of 51
$513
CO $6,761MD $347
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.