How much rates vary
Facilitymedian $1,820 · 10th to 90th $977 to $4,467Professionalmedian $427 · 10th to 90th $295 to $589
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 $426.58 Median $1,288.25 Typical High $2,454.71 | Facility | None | $426.58 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $436.52 | Professional | None | $338.84 | $426.58 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,621.81 | $3,235.94 | $4,466.84 |
BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Professional | None | $331.13 | $331.13 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,479.11 Typical High $1,949.84 | Facility | None | $562.34 | $1,479.11 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $724.44 | Professional | None | $245.47 | $446.68 | $724.44 |
Qualchoice Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | None | $281.84 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $4,677.35 | Facility | None | $1,096.48 | $1,513.56 | $4,677.35 |
United Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $616.60 | Professional | None | $295.12 | $338.84 | $616.60 |
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 $208.93 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $208.93 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $302.00 |
Where Arkansas sits
The same service costs 5.3 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 $5,518MT $1,050
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.