How much rates vary
Facilitymedian $1,445 · 10th to 90th $339 to $3,890Professionalmedian $324 · 10th to 90th $240 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 $245.47 Median $380.19 Typical High $794.33 | Facility | None | $245.47 | $380.19 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $537.03 | Professional | None | $245.47 | $338.84 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $234.42 Median $281.84 Typical High $457.09 | Professional | None | $234.42 | $281.84 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $426.58 Typical High $2,041.74 | Facility | None | $263.03 | $426.58 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $436.52 | Professional | None | $263.03 | $363.08 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,445.44 Typical High $1,659.59 | Facility | None | $446.68 | $1,445.44 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $2,089.30 | Professional | None | $269.15 | $380.19 | $2,089.30 |
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 $257.04 Median $346.74 Typical High $602.56 | Professional | None | $257.04 | $346.74 | $602.56 |
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 $123.03 Median $169.82 Typical High $194.98 | Facility | 52 · Reduced service | $123.03 | $169.82 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $67.61 Typical High $79.43 | Facility | 53 · Discontinued | $48.98 | $67.61 | $79.43 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $186.21 Median $251.19 Typical High $295.12 | Facility | 54 · Surgery only | $186.21 | $251.19 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $37.15 Median $50.12 Typical High $58.88 | Facility | 55 · Aftercare only | $37.15 | $50.12 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.88 Typical High $38.90 | Facility | 56 · Pre-op care only | $24.55 | $33.88 | $38.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $234.42 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $173.78 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $123.03 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $48.98 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $245.47 Typical High $288.40 | Professional | 54 · Surgery only | $186.21 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $37.15 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $24.55 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $229.09 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $173.78 | $229.09 | $269.15 |
Where Kentucky sits
The same service costs 6.1 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 $6,346MT $1,043
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.