How much rates vary
Facilitymedian $1,660 · 10th to 90th $501 to $4,169Professionalmedian $437 · 10th to 90th $355 to $692
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 $398.11 Median $398.11 Typical High $5,248.07 | Facility | None | $398.11 | $398.11 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $588.84 | Professional | None | $398.11 | $398.11 | $588.84 |
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 $354.81 Median $436.52 Typical High $645.65 | Professional | None | $354.81 | $436.52 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $2,344.23 | Facility | None | $371.54 | $602.56 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $630.96 | Professional | None | $380.19 | $537.03 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,659.59 Typical High $1,778.28 | Facility | None | $676.08 | $1,659.59 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $3,162.28 | Professional | None | $398.11 | $602.56 | $3,162.28 |
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 $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 $389.05 Median $524.81 Typical High $776.25 | Professional | None | $389.05 | $524.81 | $776.25 |
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 $199.53 Median $199.53 Typical High $269.15 | Professional | 52 · Reduced service | $199.53 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $107.15 | Professional | 53 · Discontinued | $79.43 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | 54 · Surgery only | $302.00 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $371.54 |
Where Kentucky sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.