How much rates vary
Facilitymedian $4,467 · 10th to 90th $631 to $12,023Professionalmedian $589 · 10th to 90th $407 to $8,511
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 $407.38 Median $3,630.78 Typical High $8,709.64 | Facility | None | $407.38 | $3,630.78 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $2,818.38 Typical High $7,943.28 | Professional | None | $407.38 | $2,818.38 | $7,943.28 |
Ambetter Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,128.61 | Professional | None | $4,897.79 | $4,897.79 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $5,754.40 Typical High $14,454.40 | Facility | None | $2,238.72 | $5,754.40 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $660.69 | Professional | None | $407.38 | $575.44 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $707.95 Typical High $5,888.44 | Facility | None | $426.58 | $707.95 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $724.44 | Professional | None | $398.11 | $588.84 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $4,466.84 | Facility | None | $34.67 | $794.33 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $4,897.79 Typical High $28,840.32 | Professional | None | $446.68 | $4,897.79 | $28,840.32 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $4,073.80 | Professional | None | $33.11 | $33.11 | $4,073.80 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $537.03 Median $4,786.30 Typical High $10,715.19 | Professional | None | $537.03 | $4,786.30 | $10,715.19 |
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 $199.53 Median $316.23 Typical High $4,265.80 | Facility | 52 · Reduced service | $199.53 | $316.23 | $4,265.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $125.89 Typical High $1,698.24 | Facility | 53 · Discontinued | $81.28 | $125.89 | $1,698.24 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $478.63 Typical High $6,309.57 | Facility | 54 · Surgery only | $302.00 | $478.63 | $6,309.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $95.50 Typical High $1,258.93 | Facility | 55 · Aftercare only | $60.26 | $95.50 | $1,258.93 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $851.14 | Facility | 56 · Pre-op care only | $39.81 | $63.10 | $851.14 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $446.68 Typical High $5,888.44 | Facility | 78 · Unplanned return to OR | $281.84 | $446.68 | $5,888.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $380.19 Typical High $2,630.27 | Professional | 52 · Reduced service | $199.53 | $380.19 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $151.36 Typical High $1,047.13 | Professional | 53 · Discontinued | $81.28 | $151.36 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $575.44 Typical High $3,890.45 | Professional | 54 · Surgery only | $302.00 | $575.44 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $114.82 Typical High $776.25 | Professional | 55 · Aftercare only | $60.26 | $114.82 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $75.86 Typical High $524.81 | Professional | 56 · Pre-op care only | $39.81 | $75.86 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $537.03 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $281.84 | $537.03 | $3,630.78 |
Where Kentucky sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,466
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.