How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,175 to $10,715Professionalmedian $1,288 · 10th to 90th $1,072 to $2,138
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 $1,202.26 Median $1,258.93 Typical High $8,511.38 | Facility | None | $1,202.26 | $1,258.93 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,288.25 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,778.28 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,288.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,905.46 Typical High $2,691.53 | Professional | 50 · Both sides | $1,584.89 | $1,905.46 | $2,691.53 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $4,897.79 | Facility | None | $1,258.93 | $1,995.26 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $3,388.44 Typical High $4,168.69 | Facility | None | $1,548.82 | $3,388.44 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $6,606.93 | Professional | None | $1,288.25 | $1,819.70 | $6,606.93 |
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 $831.76 Median $2,290.87 Typical High $6,760.83 | Facility | None | $831.76 | $2,290.87 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,412.54 | $2,511.89 |
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 $588.84 Median $630.96 Typical High $645.65 | Professional | 52 · Reduced service | $588.84 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $257.04 | Professional | 53 · Discontinued | $234.42 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $977.24 | Professional | 54 · Surgery only | $870.96 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $194.98 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $912.01 |
Where Kentucky sits
The same service costs 3.0 times more in Alaska than in Vermont. 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 $12,999VT $4,294
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.