How much rates vary
Facilitymedian $2,291 · 10th to 90th $741 to $8,511Professionalmedian $575 · 10th to 90th $457 to $813
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 $575.44 Median $741.31 Typical High $8,511.38 | Facility | None | $575.44 | $741.31 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $741.31 | Professional | None | $575.44 | $588.84 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $758.58 | Professional | None | $457.09 | $562.34 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $354.81 Typical High $478.63 | Professional | 62 · Two surgeons | $288.40 | $354.81 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $2,818.38 | Facility | None | $537.03 | $891.25 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $912.01 | Professional | None | $489.78 | $660.69 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,949.84 Typical High $2,290.87 | Facility | None | $741.31 | $1,949.84 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $3,311.31 | Professional | None | $562.34 | $630.96 | $3,311.31 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $891.25 | Professional | None | $524.81 | $707.95 | $891.25 |
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 $288.40 Median $295.12 Typical High $363.08 | Professional | 52 · Reduced service | $288.40 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $117.49 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $446.68 Typical High $549.54 | Professional | 54 · Surgery only | $436.52 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $58.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $416.87 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $407.38 | $416.87 | $512.86 |
Where Kentucky sits
The same service costs 4.0 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 $7,771MT $1,932
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.