How much rates vary
Facilitymedian $2,570 · 10th to 90th $724 to $8,511Professionalmedian $692 · 10th to 90th $550 to $1,175
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 $588.84 Median $724.44 Typical High $8,511.38 | Facility | None | $588.84 | $724.44 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,071.52 | Professional | None | $588.84 | $645.65 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,174.90 | Professional | None | $537.03 | $676.08 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,023.29 Typical High $1,737.80 | Professional | 50 · Both sides | $812.83 | $1,023.29 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $426.58 Typical High $741.31 | Professional | 62 · Two surgeons | $338.84 | $426.58 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $1,023.29 Typical High $5,888.44 | Facility | None | $630.96 | $1,023.29 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,047.13 | Professional | None | $588.84 | $870.96 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $4,466.84 | Facility | None | $741.31 | $2,290.87 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $5,888.44 | Professional | None | $630.96 | $812.83 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $281.84 | Professional | None | $33.11 | $33.11 | $281.84 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,174.90 | Professional | None | $630.96 | $776.25 | $1,174.90 |
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 $295.12 Median $323.59 Typical High $416.87 | Professional | 52 · Reduced service | $295.12 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $165.96 | Professional | 53 · Discontinued | $117.49 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $478.63 Typical High $616.60 | Professional | 54 · Surgery only | $446.68 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $123.03 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $446.68 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $416.87 | $446.68 | $575.44 |
Where Kentucky sits
The same service costs 4.8 times more in Alaska than in Montana. 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 $10,454MT $2,169
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.