How much rates vary
Facilitymedian $2,188 · 10th to 90th $646 to $8,318Professionalmedian $550 · 10th to 90th $437 to $813
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 $602.56 Typical High $8,511.38 | Facility | None | $489.78 | $602.56 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $724.44 | Professional | None | $489.78 | $562.34 | $724.44 |
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 $436.52 Median $512.86 Typical High $707.95 | Professional | None | $436.52 | $512.86 | $707.95 |
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 $870.96 | Professional | None | $588.84 | $724.44 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $2,290.87 | Facility | None | $933.25 | $1,905.46 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $3,388.44 | Professional | None | $524.81 | $676.08 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $223.87 | Professional | None | $33.11 | $33.11 | $223.87 |
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 $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 $323.59 | Professional | 52 · Reduced service | $245.47 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $371.54 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $446.68 |
Where Kentucky sits
The same service costs 4.6 times more in Alabama 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
AL $8,423MT $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.