How much rates vary
Facilitymedian $2,344 · 10th to 90th $617 to $8,511Professionalmedian $550 · 10th to 90th $427 to $832
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 $489.78 Median $616.60 Typical High $3,235.94 | Facility | None | $489.78 | $616.60 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $891.25 | Professional | None | $489.78 | $575.44 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $426.58 Median $512.86 Typical High $691.83 | Professional | None | $426.58 | $512.86 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $851.14 Typical High $2,691.53 | Facility | None | $524.81 | $851.14 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $891.25 | Professional | None | $588.84 | $724.44 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $2,290.87 | Facility | None | $954.99 | $1,905.46 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $3,235.94 | Professional | None | $512.86 | $676.08 | $3,235.94 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,000.00 | Professional | None | $501.19 | $645.65 | $1,000.00 |
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 $245.47 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $245.47 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $97.72 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $371.54 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $426.58 |
Where Kentucky sits
The same service costs 4.7 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 $8,820MT $1,888
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.