How much rates vary
Facilitymedian $1,585 · 10th to 90th $263 to $4,169Professionalmedian $316 · 10th to 90th $191 to $550
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 $208.93 Median $263.03 Typical High $851.14 | Facility | None | $208.93 | $263.03 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $389.05 | Professional | None | $208.93 | $263.03 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $549.54 | Professional | None | $181.97 | $323.59 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $2,818.38 | Facility | None | $208.93 | $346.74 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $354.81 | Professional | None | $208.93 | $302.00 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $1,659.59 Typical High $2,089.30 | Facility | None | $371.54 | $1,659.59 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $1,737.80 | Professional | None | $223.87 | $302.00 | $1,737.80 |
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 $213.80 Median $316.23 Typical High $467.74 | Professional | None | $213.80 | $316.23 | $467.74 |
12 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 Facility Modifier 52 · Reduced service Typical Low $104.71 Median $128.82 Typical High $162.18 | Facility | 52 · Reduced service | $104.71 | $128.82 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $52.48 Typical High $64.57 | Facility | 53 · Discontinued | $41.69 | $52.48 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $194.98 Typical High $245.47 | Facility | 54 · Surgery only | $154.88 | $194.98 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $38.90 Typical High $48.98 | Facility | 55 · Aftercare only | $31.62 | $38.90 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.30 Typical High $32.36 | Facility | 56 · Pre-op care only | $20.89 | $26.30 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $181.97 Typical High $229.09 | Facility | 78 · Unplanned return to OR | $144.54 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $128.82 Typical High $147.91 | Professional | 52 · Reduced service | $104.71 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $41.69 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $190.55 Typical High $218.78 | Professional | 54 · Surgery only | $154.88 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $38.02 Typical High $43.65 | Professional | 55 · Aftercare only | $31.62 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $25.70 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.89 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $177.83 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $144.54 | $177.83 | $204.17 |
Where Kentucky sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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 $5,029WV $590
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.