How much rates vary
Facilitymedian $2,884 · 10th to 90th $631 to $10,715Professionalmedian $468 · 10th to 90th $380 to $724
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 $407.38 Median $630.96 Typical High $5,495.41 | Facility | None | $407.38 | $630.96 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $776.25 | Professional | None | $407.38 | $478.63 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,584.89 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $676.08 | Professional | None | $380.19 | $457.09 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $707.95 Typical High $2,691.53 | Facility | None | $371.54 | $707.95 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $724.44 | Professional | None | $436.52 | $588.84 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $3,548.13 | Facility | None | $776.25 | $1,905.46 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $3,311.31 | Professional | None | $446.68 | $562.34 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $169.82 | Professional | None | $33.11 | $33.11 | $169.82 |
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 $416.87 Median $537.03 Typical High $812.83 | Professional | None | $416.87 | $537.03 | $812.83 |
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 $204.17 Median $234.42 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $81.28 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $302.00 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $46.77 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $323.59 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $281.84 | $323.59 | $380.19 |
Where Kentucky sits
The same service costs 5.4 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 $8,312MT $1,553
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.