How much rates vary
Facilitymedian $1,995 · 10th to 90th $759 to $8,128Professionalmedian $759 · 10th to 90th $603 to $1,202
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 $660.69 Median $812.83 Typical High $2,630.27 | Facility | None | $660.69 | $812.83 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,023.29 | Professional | None | $660.69 | $758.58 | $1,023.29 |
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 $602.56 Median $724.44 Typical High $1,122.02 | Professional | None | $602.56 | $724.44 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $1,148.15 Typical High $2,691.53 | Facility | None | $707.95 | $1,148.15 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,174.90 | Professional | None | $707.95 | $954.99 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $1,995.26 | Facility | None | $891.25 | $1,819.70 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $5,370.32 | Professional | None | $741.31 | $933.25 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $295.12 | Professional | None | $33.11 | $33.11 | $295.12 |
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 $691.83 Median $851.14 Typical High $1,318.26 | Professional | None | $691.83 | $851.14 | $1,318.26 |
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 $331.13 Median $380.19 Typical High $501.19 | Professional | 52 · Reduced service | $331.13 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $151.36 Typical High $204.17 | Professional | 53 · Discontinued | $131.83 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $575.44 Typical High $758.58 | Professional | 54 · Surgery only | $489.78 | $575.44 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $151.36 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $75.86 Typical High $102.33 | Professional | 56 · Pre-op care only | $66.07 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $707.95 |
Where Kentucky sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.