How much rates vary
Facilitymedian $1,995 · 10th to 90th $407 to $7,943Professionalmedian $355 · 10th to 90th $275 to $562
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 $316.23 Median $316.23 Typical High $851.14 | Facility | None | $316.23 | $316.23 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $501.19 | Professional | None | $316.23 | $331.13 | $501.19 |
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 $269.15 Median $354.81 Typical High $512.86 | Professional | None | $269.15 | $354.81 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $524.81 Typical High $758.58 | Professional | 50 · Both sides | $407.38 | $524.81 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $2,818.38 | Facility | None | $295.12 | $489.78 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $501.19 | Professional | None | $275.42 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $2,089.30 | Facility | None | $537.03 | $1,862.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $2,137.96 | Professional | None | $309.03 | $489.78 | $2,137.96 |
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 $316.23 Median $426.58 Typical High $588.84 | Professional | None | $316.23 | $426.58 | $588.84 |
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 $158.49 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $158.49 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | 53 · Discontinued | $63.10 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $40.74 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $281.84 |
Where Kentucky 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.