How much rates vary
Facilitymedian $1,479 · 10th to 90th $407 to $4,169Professionalmedian $347 · 10th to 90th $240 to $550
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 $281.84 Median $426.58 Typical High $851.14 | Facility | None | $281.84 | $426.58 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $588.84 | Professional | None | $281.84 | $426.58 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $467.74 | Professional | None | $223.87 | $323.59 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $489.78 Typical High $691.83 | Professional | 50 · Both sides | $338.84 | $489.78 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $2,041.74 | Facility | None | $295.12 | $489.78 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $501.19 | Professional | None | $275.42 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,412.54 Typical High $1,659.59 | Facility | None | $489.78 | $1,412.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $2,754.23 | Professional | None | $309.03 | $478.63 | $2,754.23 |
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 $263.03 Median $389.05 Typical High $691.83 | Professional | None | $263.03 | $389.05 | $691.83 |
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 $204.17 Typical High $245.47 | Facility | 52 · Reduced service | $141.25 | $204.17 | $245.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $81.28 Typical High $97.72 | Facility | 53 · Discontinued | $56.23 | $81.28 | $97.72 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $213.80 Median $309.03 Typical High $363.08 | Facility | 54 · Surgery only | $213.80 | $309.03 | $363.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $61.66 Typical High $72.44 | Facility | 55 · Aftercare only | $42.66 | $61.66 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $40.74 Typical High $48.98 | Facility | 56 · Pre-op care only | $28.18 | $40.74 | $48.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $288.40 Typical High $338.84 | Facility | 78 · Unplanned return to OR | $199.53 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $199.53 Typical High $245.47 | Professional | 52 · Reduced service | $141.25 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $79.43 Typical High $97.72 | Professional | 53 · Discontinued | $56.23 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $295.12 Typical High $363.08 | Professional | 54 · Surgery only | $213.80 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $58.88 Typical High $72.44 | Professional | 55 · Aftercare only | $42.66 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $39.81 Typical High $48.98 | Professional | 56 · Pre-op care only | $28.18 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $275.42 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $199.53 | $275.42 | $338.84 |
Where Kentucky sits
The same service costs 5.3 times more in Colorado 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
CO $6,438MT $1,226
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.