How much rates vary
Facilitymedian $1,862 · 10th to 90th $708 to $7,586Professionalmedian $708 · 10th to 90th $589 to $1,072
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 $602.56 Median $707.95 Typical High $2,630.27 | Facility | None | $602.56 | $707.95 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $776.25 | Professional | None | $602.56 | $645.65 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $588.84 Median $691.83 Typical High $912.01 | Professional | None | $588.84 | $691.83 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,548.82 | Facility | None | $575.44 | $1,071.52 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,071.52 | Professional | None | $660.69 | $891.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,148.15 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $4,073.80 | Professional | None | $691.83 | $912.01 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $354.81 | Professional | None | $33.11 | $33.11 | $354.81 |
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 $676.08 Median $933.25 Typical High $1,258.93 | Professional | None | $676.08 | $933.25 | $1,258.93 |
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 $302.00 Median $323.59 Typical High $389.05 | Professional | 52 · Reduced service | $302.00 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $154.88 | Professional | 53 · Discontinued | $120.23 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $489.78 Typical High $588.84 | Professional | 54 · Surgery only | $457.09 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $117.49 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $64.57 Typical High $77.62 | Professional | 56 · Pre-op care only | $60.26 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $457.09 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $426.58 | $457.09 | $549.54 |
Where Kentucky sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.