How much rates vary
Facilitymedian $832 · 10th to 90th $457 to $3,548Professionalmedian $776 · 10th to 90th $617 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 $630.96 Median $776.25 Typical High $3,801.89 | Facility | None | $630.96 | $776.25 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $933.25 | Professional | None | $630.96 | $707.95 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,122.02 | Professional | None | $616.60 | $776.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,148.15 Typical High $1,698.24 | Professional | 50 · Both sides | $933.25 | $1,148.15 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $1,096.48 | Facility | None | $575.44 | $691.83 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,122.02 | Professional | None | $616.60 | $912.01 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,000.00 Typical High $1,230.27 | Facility | None | $34.67 | $1,000.00 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $4,897.79 | Professional | None | $691.83 | $912.01 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $426.58 | Professional | None | $33.11 | $33.11 | $426.58 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,318.26 | Professional | None | $741.31 | $891.25 | $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 $316.23 Median $354.81 Typical High $457.09 | Professional | 52 · Reduced service | $316.23 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $181.97 | Professional | 53 · Discontinued | $125.89 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $676.08 | Professional | 54 · Surgery only | $467.74 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $70.79 Typical High $91.20 | Professional | 56 · Pre-op care only | $63.10 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $630.96 |
Where Kentucky sits
The same service costs 4.3 times more in Alaska than in Alabama. 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 $6,582AL $1,537
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.