How much rates vary
Facilitymedian $1,698 · 10th to 90th $437 to $7,413Professionalmedian $251 · 10th to 90th $135 to $2,884
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 $288.40 Median $436.52 Typical High $3,388.44 | Facility | None | $288.40 | $436.52 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $3,388.44 | Professional | None | $380.19 | $446.68 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $338.84 | Professional | None | $125.89 | $162.18 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $676.08 Typical High $15,488.17 | Facility | None | $354.81 | $676.08 | $15,488.17 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $691.83 | Professional | None | $457.09 | $562.34 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,318.26 Typical High $10,232.93 | Facility | None | $776.25 | $1,318.26 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $489.78 Typical High $23,442.29 | Professional | None | $218.78 | $489.78 | $23,442.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $83.18 | Professional | None | $33.11 | $33.11 | $83.18 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $8,511.38 | Facility | None | $977.24 | $1,862.09 | $8,511.38 |
United Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $2,238.72 | Professional | None | $169.82 | $257.04 | $2,238.72 |
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 $141.25 Median $218.78 Typical High $1,659.59 | Facility | 52 · Reduced service | $141.25 | $218.78 | $1,659.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $57.54 Median $87.10 Typical High $676.08 | Facility | 53 · Discontinued | $57.54 | $87.10 | $676.08 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $213.80 Median $331.13 Typical High $2,511.89 | Facility | 54 · Surgery only | $213.80 | $331.13 | $2,511.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $66.07 Typical High $501.19 | Facility | 55 · Aftercare only | $42.66 | $66.07 | $501.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.84 Median $43.65 Typical High $338.84 | Facility | 56 · Pre-op care only | $28.84 | $43.65 | $338.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $309.03 Typical High $2,344.23 | Facility | 78 · Unplanned return to OR | $199.53 | $309.03 | $2,344.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $218.78 Typical High $1,659.59 | Professional | 52 · Reduced service | $186.21 | $218.78 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $87.10 Typical High $676.08 | Professional | 53 · Discontinued | $75.86 | $87.10 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $331.13 Typical High $2,511.89 | Professional | 54 · Surgery only | $281.84 | $331.13 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $66.07 Typical High $501.19 | Professional | 55 · Aftercare only | $56.23 | $66.07 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $43.65 Typical High $338.84 | Professional | 56 · Pre-op care only | $38.02 | $43.65 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $309.03 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $263.03 | $309.03 | $2,344.23 |
Where Kentucky sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.