How much rates vary
Facilitymedian $1,660 · 10th to 90th $309 to $4,266Professionalmedian $309 · 10th to 90th $224 to $427
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 $251.19 Median $316.23 Typical High $851.14 | Facility | None | $251.19 | $316.23 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $398.11 | Professional | None | $251.19 | $309.03 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $4,265.80 | Facility | None | $831.76 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $426.58 | Professional | None | $223.87 | $269.15 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $4,897.79 | Facility | None | $234.42 | $380.19 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $380.19 | Professional | None | $213.80 | $295.12 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,659.59 Typical High $3,630.78 | Facility | None | $398.11 | $1,659.59 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $1,621.81 | Professional | None | $245.47 | $309.03 | $1,621.81 |
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 $257.04 Median $363.08 Typical High $457.09 | Professional | None | $257.04 | $363.08 | $457.09 |
12 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 Facility Modifier 52 · Reduced service Typical Low $125.89 Median $154.88 Typical High $194.98 | Facility | 52 · Reduced service | $125.89 | $154.88 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $50.12 Median $63.10 Typical High $79.43 | Facility | 53 · Discontinued | $50.12 | $63.10 | $79.43 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $186.21 Median $234.42 Typical High $295.12 | Facility | 54 · Surgery only | $186.21 | $234.42 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $37.15 Median $46.77 Typical High $58.88 | Facility | 55 · Aftercare only | $37.15 | $46.77 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.90 Typical High $39.81 | Facility | 56 · Pre-op care only | $25.12 | $30.90 | $39.81 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $218.78 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $173.78 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $154.88 Typical High $194.98 | Professional | 52 · Reduced service | $125.89 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $61.66 Typical High $79.43 | Professional | 53 · Discontinued | $50.12 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $234.42 Typical High $295.12 | Professional | 54 · Surgery only | $186.21 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $46.77 Typical High $58.88 | Professional | 55 · Aftercare only | $37.15 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.12 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $218.78 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $173.78 | $218.78 | $275.42 |
Where Kentucky sits
The same service costs 8.7 times more in Alaska than in North Dakota. 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 $7,504ND $861
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.