How much rates vary
Facilitymedian $1,698 · 10th to 90th $631 to $4,266Professionalmedian $692 · 10th to 90th $550 to $1,259
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 $562.34 Median $691.83 Typical High $5,248.07 | Facility | None | $562.34 | $691.83 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,071.52 | Professional | None | $562.34 | $630.96 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $891.25 | Professional | None | $562.34 | $562.34 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,258.93 | Professional | None | $549.54 | $691.83 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,047.13 Typical High $1,862.09 | Professional | 50 · Both sides | $812.83 | $1,047.13 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $436.52 Typical High $776.25 | Professional | 62 · Two surgeons | $346.74 | $436.52 | $776.25 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $2,691.53 | Facility | None | $602.56 | $977.24 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,000.00 | Professional | None | $602.56 | $831.76 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,659.59 Typical High $1,949.84 | Facility | None | $724.44 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $6,025.60 | Professional | None | $616.60 | $851.14 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $363.08 | Professional | None | $33.11 | $33.11 | $363.08 |
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 $645.65 Median $794.33 Typical High $1,174.90 | Professional | None | $645.65 | $794.33 | $1,174.90 |
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 $281.84 Median $316.23 Typical High $416.87 | Professional | 52 · Reduced service | $281.84 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $165.96 | Professional | 53 · Discontinued | $112.20 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $616.60 | Professional | 54 · Surgery only | $416.87 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $95.50 Typical High $123.03 | Professional | 55 · Aftercare only | $83.18 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $83.18 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $389.05 | $446.68 | $575.44 |
Where Kentucky sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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
WI $7,283HI $2,091
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.