How much rates vary
Facilitymedian $1,995 · 10th to 90th $832 to $8,128Professionalmedian $933 · 10th to 90th $759 to $1,445
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 $1,023.29 Typical High $2,630.27 | Facility | None | $794.33 | $1,023.29 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,202.26 | Professional | None | $831.76 | $954.99 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $758.58 Median $891.25 Typical High $1,258.93 | Professional | None | $758.58 | $891.25 | $1,258.93 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $2,691.53 | Facility | None | $891.25 | $1,445.44 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,479.11 | Professional | None | $891.25 | $1,202.26 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $1,995.26 | Facility | None | $1,096.48 | $1,819.70 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $6,456.54 | Professional | None | $912.01 | $1,122.02 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $218.78 | Professional | None | $33.11 | $33.11 | $218.78 |
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 $851.14 Median $1,096.48 Typical High $1,659.59 | Professional | None | $851.14 | $1,096.48 | $1,659.59 |
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 $407.38 Median $478.63 Typical High $562.34 | Professional | 52 · Reduced service | $407.38 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $190.55 Typical High $223.87 | Professional | 53 · Discontinued | $165.96 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $616.60 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $123.03 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $95.50 Typical High $112.20 | Professional | 56 · Pre-op care only | $83.18 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $575.44 | $660.69 | $776.25 |
Where Kentucky sits
The same service costs 3.1 times more in Alaska than in Kansas. 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 $8,439KS $2,701
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.