How much rates vary
Facilitymedian $1,660 · 10th to 90th $589 to $5,370Professionalmedian $457 · 10th to 90th $389 to $776
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 $457.09 Median $616.60 Typical High $912.01 | Facility | None | $457.09 | $616.60 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $660.69 | Professional | None | $457.09 | $478.63 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $389.05 Median $457.09 Typical High $602.56 | Professional | None | $389.05 | $457.09 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $707.95 Typical High $6,025.60 | Facility | None | $426.58 | $707.95 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $707.95 | Professional | None | $398.11 | $524.81 | $707.95 |
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 $446.68 Median $575.44 Typical High $2,187.76 | Professional | None | $446.68 | $575.44 | $2,187.76 |
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 $5,754.40 | Facility | None | $707.95 | $1,174.90 | $5,754.40 |
United Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $831.76 | Professional | None | $446.68 | $630.96 | $831.76 |
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 $229.09 Median $234.42 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $93.33 Typical High $117.49 | Professional | 53 · Discontinued | $91.20 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $354.81 Typical High $436.52 | Professional | 54 · Surgery only | $346.74 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $58.88 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | GC · Resident with teaching physician | $512.86 | $512.86 | $512.86 |
Where Kentucky sits
The same service costs 5.9 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 $8,723MT $1,483
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.