How much rates vary
Facilitymedian $1,778 · 10th to 90th $513 to $7,244Professionalmedian $457 · 10th to 90th $339 to $741
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 $380.19 Median $524.81 Typical High $1,000.00 | Facility | None | $380.19 | $524.81 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $954.99 | Professional | None | $380.19 | $512.86 | $954.99 |
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 $331.13 Median $416.87 Typical High $602.56 | Professional | None | $331.13 | $416.87 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $660.69 Typical High $2,041.74 | Facility | None | $398.11 | $660.69 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $691.83 | Professional | None | $380.19 | $562.34 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $1,862.09 | Facility | None | $758.58 | $1,445.44 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $3,311.31 | Professional | None | $426.58 | $575.44 | $3,311.31 |
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 $363.08 Median $467.74 Typical High $831.76 | Professional | None | $363.08 | $467.74 | $831.76 |
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 $190.55 Median $257.04 Typical High $295.12 | Facility | 52 · Reduced service | $190.55 | $257.04 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $75.86 Median $102.33 Typical High $117.49 | Facility | 53 · Discontinued | $75.86 | $102.33 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $288.40 Median $389.05 Typical High $436.52 | Facility | 54 · Surgery only | $288.40 | $389.05 | $436.52 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $57.54 Median $77.62 Typical High $87.10 | Facility | 55 · Aftercare only | $57.54 | $77.62 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.02 Median $51.29 Typical High $58.88 | Facility | 56 · Pre-op care only | $38.02 | $51.29 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $363.08 Typical High $407.38 | Facility | 78 · Unplanned return to OR | $269.15 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $190.55 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $75.86 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $288.40 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $74.13 Typical High $87.10 | Professional | 55 · Aftercare only | $57.54 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.02 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $346.74 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $269.15 | $346.74 | $407.38 |
Where Kentucky sits
The same service costs 5.2 times more in Colorado 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
CO $6,580WV $1,277
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.