How much rates vary
Facilitymedian $2,239 · 10th to 90th $891 to $41,687Professionalmedian $1,072 · 10th to 90th $759 to $1,778
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 $912.01 Median $1,202.26 Typical High $5,495.41 | Facility | None | $912.01 | $1,202.26 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,862.09 | Professional | None | $812.83 | $1,047.13 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $31,622.78 Typical High $75,857.76 | Facility | None | $9,120.11 | $31,622.78 | $75,857.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,380.38 | Professional | None | $758.58 | $977.24 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $616.60 Typical High $870.96 | Professional | 62 · Two surgeons | $478.63 | $616.60 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $1,318.26 Typical High $41,686.94 | Facility | None | $707.95 | $1,318.26 | $41,686.94 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,348.96 | Professional | None | $758.58 | $1,148.15 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,412.54 Typical High $29,512.09 | Facility | None | $34.67 | $1,412.54 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,659.59 Typical High $5,495.41 | Professional | None | $851.14 | $1,659.59 | $5,495.41 |
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 $1,096.48 Median $5,128.61 Typical High $57,543.99 | Facility | None | $1,096.48 | $5,128.61 | $57,543.99 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,380.38 | $1,819.70 |
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 $457.09 Median $501.19 Typical High $660.69 | Professional | 52 · Reduced service | $457.09 | $501.19 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $263.03 | Professional | 53 · Discontinued | $181.97 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Professional | 54 · Surgery only | $676.08 | $758.58 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $199.53 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $100.00 Typical High $131.83 | Professional | 56 · Pre-op care only | $91.20 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $933.25 |
Where Kentucky sits
The same service costs 19.9 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 $53,750MT $2,699
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.