How much rates vary
Facilitymedian $1,660 · 10th to 90th $631 to $3,981Professionalmedian $741 · 10th to 90th $603 to $1,288
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 $676.08 Median $758.58 Typical High $2,290.87 | Facility | None | $676.08 | $758.58 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,348.96 | Professional | None | $676.08 | $758.58 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $912.01 | Professional | None | $602.56 | $707.95 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $1,659.59 | Facility | None | $707.95 | $1,174.90 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,202.26 | Professional | None | $660.69 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,344.23 | Facility | None | $1,288.25 | $1,659.59 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $4,168.69 | Professional | None | $691.83 | $794.33 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,380.38 | Professional | None | $676.08 | $794.33 | $1,380.38 |
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 $338.84 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $467.74 | $512.86 | $562.34 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Georgia. 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 $7,038GA $2,000
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.