How much rates vary
Facilitymedian $1,622 · 10th to 90th $355 to $11,749Professionalmedian $302 · 10th to 90th $245 to $479
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 $263.03 Median $302.00 Typical High $3,801.89 | Facility | None | $263.03 | $302.00 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $354.81 | Professional | None | $263.03 | $281.84 | $354.81 |
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 $245.47 Median $295.12 Typical High $436.52 | Professional | None | $245.47 | $295.12 | $436.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $47.86 Typical High $70.79 | Professional | 80 · Assistant surgeon | $38.90 | $47.86 | $70.79 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $41.69 Typical High $61.66 | Professional | AS · PA/NP assist | $34.67 | $41.69 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $467.74 Typical High $33,884.42 | Facility | None | $281.84 | $467.74 | $33,884.42 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $467.74 | Professional | None | $281.84 | $380.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $16,218.10 | Facility | None | $549.54 | $1,318.26 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $1,862.09 | Professional | None | $295.12 | $380.19 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $158.49 | Professional | None | $33.11 | $33.11 | $158.49 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $13,182.57 | Facility | None | $1,148.15 | $3,162.28 | $13,182.57 |
United Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $537.03 | Professional | None | $275.42 | $380.19 | $537.03 |
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 $131.83 Median $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $131.83 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $56.23 Typical High $70.79 | Professional | 53 · Discontinued | $52.48 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $208.93 Typical High $269.15 | Professional | 54 · Surgery only | $194.98 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $53.70 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.18 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.30 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $194.98 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $181.97 | $194.98 | $251.19 |
Where Kentucky sits
The same service costs 29.1 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 $30,626MT $1,051
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.