How much rates vary
Facilitymedian $1,905 · 10th to 90th $457 to $7,244Professionalmedian $427 · 10th to 90th $275 to $708
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 $346.74 Median $457.09 Typical High $794.33 | Facility | None | $346.74 | $457.09 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $575.44 | Professional | None | $346.74 | $426.58 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $616.60 | Professional | None | $269.15 | $323.59 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $602.56 Typical High $2,691.53 | Facility | None | $316.23 | $602.56 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $616.60 | Professional | None | $371.54 | $501.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,819.70 Typical High $1,995.26 | Facility | None | $562.34 | $1,819.70 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $3,235.94 | Professional | None | $389.05 | $524.81 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $120.23 | Professional | None | $33.11 | $33.11 | $120.23 |
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 $371.54 Median $537.03 Typical High $812.83 | Professional | None | $371.54 | $537.03 | $812.83 |
12 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 Facility Modifier 52 · Reduced service Typical Low $169.82 Median $229.09 Typical High $302.00 | Facility | 52 · Reduced service | $169.82 | $229.09 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $91.20 Typical High $123.03 | Facility | 53 · Discontinued | $69.18 | $91.20 | $123.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $346.74 Typical High $457.09 | Facility | 54 · Surgery only | $257.04 | $346.74 | $457.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $69.18 Typical High $91.20 | Facility | 55 · Aftercare only | $51.29 | $69.18 | $91.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $61.66 | Facility | 56 · Pre-op care only | $34.67 | $45.71 | $61.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $323.59 Typical High $426.58 | Facility | 78 · Unplanned return to OR | $239.88 | $323.59 | $426.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $229.09 Typical High $288.40 | Professional | 52 · Reduced service | $169.82 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $91.20 Typical High $114.82 | Professional | 53 · Discontinued | $69.18 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $346.74 Typical High $426.58 | Professional | 54 · Surgery only | $257.04 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $69.18 Typical High $85.11 | Professional | 55 · Aftercare only | $51.29 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $57.54 | Professional | 56 · Pre-op care only | $34.67 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $323.59 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $239.88 | $323.59 | $398.11 |
Where Kentucky sits
The same service costs 5.8 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 $1,458
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.