How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,259 to $11,220Professionalmedian $1,413 · 10th to 90th $1,072 to $2,188
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 $977.24 Median $2,951.21 Typical High $7,762.47 | Facility | None | $977.24 | $2,951.21 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,621.81 | Professional | None | $977.24 | $1,258.93 | $1,621.81 |
BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $14,454.40 | Facility | None | $4,570.88 | $6,760.83 | $14,454.40 |
BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,230.27 | $1,778.28 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,370.32 Typical High $6,760.83 | Facility | None | $776.25 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,412.54 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $4,570.88 | Professional | None | $1,096.48 | $1,778.28 | $4,570.88 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,380.38 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,288.25 | $4,073.80 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,445.44 | $2,398.83 |
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 $489.78 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $194.98 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $870.96 | $870.96 |
Where Illinois sits
The same service costs 3.4 times more in Alaska 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
AK $11,546MT $3,436
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.