How much rates vary
Facilitymedian $2,042 · 10th to 90th $832 to $7,586Professionalmedian $1,175 · 10th to 90th $977 to $2,089
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 $794.33 Median $1,348.96 Typical High $2,630.27 | Facility | None | $794.33 | $1,348.96 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,230.27 | $1,584.89 |
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 $977.24 Median $1,148.15 Typical High $1,548.82 | Professional | None | $977.24 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,698.24 Typical High $2,344.23 | Professional | 50 · Both sides | $1,445.44 | $1,698.24 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,202.26 | $1,862.09 |
CareSource Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,584.89 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,995.26 Typical High $6,025.60 | Facility | None | $34.67 | $1,995.26 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $5,495.41 | Professional | None | $1,202.26 | $1,548.82 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $794.33 | Professional | None | $33.11 | $33.11 | $794.33 |
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 $1,318.26 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,445.44 | $2,290.87 |
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 $537.03 Median $616.60 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $245.47 Typical High $269.15 | Professional | 53 · Discontinued | $213.80 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $812.83 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $107.15 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $933.25 |
Where Kentucky sits
The same service costs 6.1 times more in Alaska than in Texas. 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 $14,041TX $2,290
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.