How much rates vary
Facilitymedian $2,754 · 10th to 90th $871 to $5,888Professionalmedian $955 · 10th to 90th $724 to $1,380
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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
BCBS Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,548.82 | Professional | None | $724.44 | $954.99 | $1,548.82 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $616.60 Typical High $1,000.00 | Professional | 54 · Surgery only | $436.52 | $616.60 | $1,000.00 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $114.82 Typical High $186.21 | Professional | 55 · Aftercare only | $79.43 | $114.82 | $186.21 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $81.28 Typical High $131.83 | Professional | 56 · Pre-op care only | $57.54 | $81.28 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,981.07 Typical High $5,623.41 | Facility | None | $676.08 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,348.96 | $1,659.59 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,380.38 | Professional | None | $660.69 | $831.76 | $1,380.38 |
3 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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $575.44 |
Where Rhode Island sits
The same service costs 5.2 times more in Alaska than in Kentucky. 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 $9,768KY $1,881
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.