How much rates vary
Facilitymedian $2,818 · 10th to 90th $724 to $10,471Professionalmedian $708 · 10th to 90th $575 to $1,072
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 $588.84 Median $758.58 Typical High $2,630.27 | Facility | None | $588.84 | $758.58 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,047.13 | Professional | None | $588.84 | $676.08 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | None | $794.33 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,202.26 | $6,165.95 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $977.24 | Professional | None | $575.44 | $691.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,047.13 Typical High $1,445.44 | Professional | 50 · Both sides | $851.14 | $1,047.13 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $891.25 Typical High $2,691.53 | Facility | None | $616.60 | $891.25 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $954.99 | Professional | None | $645.65 | $707.95 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $3,548.13 | Facility | None | $1,122.02 | $1,862.09 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $4,265.80 | Professional | None | $645.65 | $831.76 | $4,265.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $446.68 | Professional | None | $33.11 | $33.11 | $446.68 |
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 $812.83 Typical High $1,230.27 | Professional | None | $645.65 | $812.83 | $1,230.27 |
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 $295.12 Median $331.13 Typical High $407.38 | Professional | 52 · Reduced service | $295.12 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $117.49 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $501.19 Typical High $602.56 | Professional | 54 · Surgery only | $436.52 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $120.23 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $58.88 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $467.74 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $407.38 | $467.74 | $562.34 |
Where Kentucky sits
The same service costs 3.6 times more in Wisconsin 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
WI $7,904MT $2,218
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.