How much rates vary
Facilitymedian $1,660 · 10th to 90th $617 to $7,244Professionalmedian $741 · 10th to 90th $550 to $1,072
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 $616.60 Median $758.58 Typical High $851.14 | Facility | None | $616.60 | $758.58 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $912.01 | Professional | None | $616.60 | $758.58 | $912.01 |
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 $524.81 Median $645.65 Typical High $954.99 | Professional | None | $524.81 | $645.65 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,659.59 | Facility | None | $645.65 | $1,071.52 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,096.48 | Professional | None | $602.56 | $933.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,288.25 Typical High $1,862.09 | Facility | None | $794.33 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $4,677.35 | Professional | None | $660.69 | $831.76 | $4,677.35 |
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 $616.60 Median $794.33 Typical High $1,348.96 | Professional | None | $616.60 | $794.33 | $1,348.96 |
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 $309.03 Median $380.19 Typical High $426.58 | Facility | 52 · Reduced service | $309.03 | $380.19 | $426.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $123.03 Median $151.36 Typical High $169.82 | Facility | 53 · Discontinued | $123.03 | $151.36 | $169.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $645.65 | Facility | 54 · Surgery only | $457.09 | $562.34 | $645.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $128.82 | Facility | 55 · Aftercare only | $91.20 | $112.20 | $128.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $85.11 | Facility | 56 · Pre-op care only | $61.66 | $75.86 | $85.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $524.81 Typical High $602.56 | Facility | 78 · Unplanned return to OR | $426.58 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $380.19 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $151.36 Typical High $169.82 | Professional | 53 · Discontinued | $123.03 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $457.09 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $91.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $426.58 | $524.81 | $602.56 |
Where Kentucky sits
The same service costs 3.7 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 $6,113DE $1,645
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.