How much rates vary
Facilitymedian $1,950 · 10th to 90th $389 to $8,318Professionalmedian $1,950 · 10th to 90th $1,585 to $3,802
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 $1,949.84 Median $2,570.40 Typical High $2,754.23 | Facility | None | $1,949.84 | $2,570.40 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,778.28 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,862.09 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $302.00 Typical High $371.54 | Professional | 80 · Assistant surgeon | $245.47 | $302.00 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $263.03 Typical High $331.13 | Professional | AS · PA/NP assist | $218.78 | $263.03 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,818.38 | Facility | None | $1,513.56 | $1,778.28 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,737.80 | $2,454.71 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,162.28 | Facility | None | $34.67 | $691.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $3,467.37 Typical High $8,511.38 | Professional | None | $1,819.70 | $3,467.37 | $8,511.38 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $3,890.45 | Professional | None | $2,238.72 | $3,019.95 | $3,890.45 |
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 $977.24 Median $1,047.13 Typical High $1,380.38 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $426.58 Typical High $562.34 | Professional | 53 · Discontinued | $389.05 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,584.89 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,445.44 | $1,584.89 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $416.87 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $275.42 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,479.11 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,479.11 | $1,949.84 |
Where Kentucky sits
The same service costs 8.0 times more in Alabama than in Washington. 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
AL $20,353WA $2,540
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.