How much rates vary
Facilitymedian $1,660 · 10th to 90th $562 to $5,370Professionalmedian $437 · 10th to 90th $372 to $741
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 $446.68 Median $562.34 Typical High $891.25 | Facility | None | $446.68 | $562.34 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $630.96 | Professional | None | $446.68 | $478.63 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $489.78 | Professional | None | $346.74 | $467.74 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,370.32 | Facility | None | $724.44 | $1,995.26 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $562.34 | Professional | None | $371.54 | $436.52 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $6,025.60 | Facility | None | $407.38 | $588.84 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $575.44 | Professional | None | $416.87 | $446.68 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $4,466.84 | Facility | None | $34.67 | $831.76 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $2,089.30 | Professional | None | $436.52 | $562.34 | $2,089.30 |
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 $5,888.44 | Facility | None | $707.95 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $812.83 | Professional | None | $426.58 | $602.56 | $812.83 |
7 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 $218.78 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $218.78 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $89.13 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $331.13 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $56.23 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $56.23 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 59 · Distinct service | $489.78 | $489.78 | $489.78 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Where Kentucky sits
The same service costs 6.1 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 $8,625MT $1,416
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.