How much rates vary
Facilitymedian $1,950 · 10th to 90th $513 to $7,586Professionalmedian $407 · 10th to 90th $316 to $575
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 $398.11 Median $512.86 Typical High $2,630.27 | Facility | None | $398.11 | $512.86 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $512.86 | Professional | None | $407.38 | $407.38 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $575.44 | Professional | None | $309.03 | $380.19 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $2,344.23 | Facility | None | $380.19 | $616.60 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $616.60 | Professional | None | $346.74 | $457.09 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $1,862.09 | Facility | None | $602.56 | $1,621.81 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $2,089.30 | Professional | None | $389.05 | $446.68 | $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 $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $616.60 | Professional | None | $380.19 | $478.63 | $616.60 |
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 $199.53 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $81.28 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $281.84 | $288.40 | $354.81 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | GC · Resident with teaching physician | $489.78 | $489.78 | $489.78 |
Where Kentucky sits
The same service costs 4.4 times more in Oklahoma 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
OK $6,113MT $1,385
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.