How much rates vary
Facilitymedian $1,820 · 10th to 90th $692 to $7,244Professionalmedian $676 · 10th to 90th $537 to $1,096
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 $676.08 Median $691.83 Typical High $1,202.26 | Facility | None | $676.08 | $691.83 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $912.01 | Professional | None | $645.65 | $758.58 | $912.01 |
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 $467.74 Median $575.44 Typical High $707.95 | Professional | None | $467.74 | $575.44 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $851.14 Typical High $1,071.52 | Professional | 50 · Both sides | $707.95 | $851.14 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $933.25 Typical High $1,737.80 | Facility | None | $501.19 | $933.25 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $977.24 | Professional | None | $645.65 | $831.76 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,258.93 Typical High $2,290.87 | Facility | None | $676.08 | $1,258.93 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $3,801.89 | Professional | None | $602.56 | $707.95 | $3,801.89 |
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 $562.34 Median $676.08 Typical High $1,096.48 | Professional | None | $562.34 | $676.08 | $1,096.48 |
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 $331.13 Median $346.74 Typical High $407.38 | Facility | 52 · Reduced service | $331.13 | $346.74 | $407.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $165.96 | Facility | 53 · Discontinued | $134.90 | $141.25 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $616.60 | Facility | 54 · Surgery only | $501.19 | $524.81 | $616.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $123.03 | Facility | 55 · Aftercare only | $100.00 | $104.71 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $81.28 | Facility | 56 · Pre-op care only | $67.61 | $69.18 | $81.28 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $467.74 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $380.19 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $575.44 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $537.03 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $537.03 | $575.44 |
Where Kentucky sits
The same service costs 3.7 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 $6,098WV $1,627
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.