How much rates vary
Facilitymedian $1,995 · 10th to 90th $617 to $8,128Professionalmedian $603 · 10th to 90th $479 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 $478.63 Median $588.84 Typical High $2,630.27 | Facility | None | $478.63 | $588.84 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $794.33 | Professional | None | $478.63 | $549.54 | $794.33 |
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 $446.68 Median $588.84 Typical High $1,071.52 | Professional | None | $446.68 | $588.84 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $2,691.53 | Facility | None | $512.86 | $831.76 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $851.14 | Professional | None | $524.81 | $707.95 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,862.09 Typical High $1,995.26 | Facility | None | $933.25 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $5,495.41 | Professional | None | $537.03 | $758.58 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $234.42 | Professional | None | $33.11 | $33.11 | $234.42 |
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 $562.34 Median $676.08 Typical High $1,023.29 | Professional | None | $562.34 | $676.08 | $1,023.29 |
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 $239.88 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $239.88 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $524.81 | Professional | 54 · Surgery only | $363.08 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $489.78 |
Where Kentucky sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.