How much rates vary
Facilitymedian $2,291 · 10th to 90th $513 to $27,542Professionalmedian $501 · 10th to 90th $389 to $851
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 $436.52 Median $512.86 Typical High $5,248.07 | Facility | None | $436.52 | $512.86 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $575.44 | Professional | None | $436.52 | $478.63 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $2,454.71 Typical High $6,760.83 | Facility | None | $724.44 | $2,454.71 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $676.08 | Professional | None | $389.05 | $467.74 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $707.95 Typical High $1,000.00 | Professional | 50 · Both sides | $575.44 | $707.95 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $33,884.42 | Facility | None | $467.74 | $776.25 | $33,884.42 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $812.83 | Professional | None | $478.63 | $691.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,659.59 Typical High $33,113.11 | Facility | None | $954.99 | $1,659.59 | $33,113.11 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $2,691.53 | Professional | None | $501.19 | $776.25 | $2,691.53 |
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 $1,513.56 Median $3,630.78 Typical High $23,988.33 | Facility | None | $1,513.56 | $3,630.78 | $23,988.33 |
United Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $954.99 | Professional | None | $537.03 | $676.08 | $954.99 |
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 $218.78 Median $239.88 Typical High $257.04 | Professional | 52 · Reduced service | $218.78 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $363.08 |
Where Kentucky sits
The same service costs 24.6 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 $43,875MT $1,787
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.