How much rates vary
Facilitymedian $1,820 · 10th to 90th $646 to $7,244Professionalmedian $692 · 10th to 90th $513 to $977
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 $562.34 Median $691.83 Typical High $794.33 | Facility | None | $562.34 | $691.83 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $891.25 | Professional | None | $562.34 | $691.83 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $912.01 | Professional | None | $501.19 | $616.60 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $1,659.59 | Facility | None | $602.56 | $977.24 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,023.29 | Professional | None | $616.60 | $870.96 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,862.09 | Facility | None | $1,047.13 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $4,265.80 | Professional | None | $588.84 | $776.25 | $4,265.80 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,230.27 | Professional | None | $562.34 | $724.44 | $1,230.27 |
12 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 Facility Modifier 52 · Reduced service Typical Low $281.84 Median $346.74 Typical High $398.11 | Facility | 52 · Reduced service | $281.84 | $346.74 | $398.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $112.20 Median $138.04 Typical High $158.49 | Facility | 53 · Discontinued | $112.20 | $138.04 | $158.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $602.56 | Facility | 54 · Surgery only | $426.58 | $524.81 | $602.56 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $85.11 Median $104.71 Typical High $120.23 | Facility | 55 · Aftercare only | $85.11 | $104.71 | $120.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $56.23 Median $69.18 Typical High $79.43 | Facility | 56 · Pre-op care only | $56.23 | $69.18 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $489.78 Typical High $562.34 | Facility | 78 · Unplanned return to OR | $398.11 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $281.84 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $112.20 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $426.58 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $85.11 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $56.23 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $489.78 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $398.11 | $489.78 | $549.54 |
Where Kentucky sits
The same service costs 3.1 times more in Alaska 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.
Physician feeFacility fee
AK $5,990MD $1,938
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.