How much rates vary
Facilitymedian $933 · 10th to 90th $240 to $3,802Professionalmedian $331 · 10th to 90th $229 to $490
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 $239.88 Median $407.38 Typical High $794.33 | Facility | None | $239.88 | $407.38 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $616.60 | Professional | None | $239.88 | $354.81 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $478.63 | Professional | None | $223.87 | $323.59 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $549.54 | Facility | None | $251.19 | $416.87 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $426.58 | Professional | None | $257.04 | $363.08 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $467.74 Typical High $1,659.59 | Facility | None | $436.52 | $467.74 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $2,290.87 | Professional | None | $263.03 | $398.11 | $2,290.87 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $588.84 | Professional | None | $234.42 | $354.81 | $588.84 |
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 $120.23 Median $177.83 Typical High $208.93 | Facility | 52 · Reduced service | $120.23 | $177.83 | $208.93 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $70.79 Typical High $83.18 | Facility | 53 · Discontinued | $47.86 | $70.79 | $83.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $269.15 Typical High $316.23 | Facility | 54 · Surgery only | $177.83 | $269.15 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $53.70 Typical High $63.10 | Facility | 55 · Aftercare only | $35.48 | $53.70 | $63.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $35.48 Typical High $41.69 | Facility | 56 · Pre-op care only | $23.99 | $35.48 | $41.69 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $251.19 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $165.96 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $120.23 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $47.86 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $263.03 Typical High $302.00 | Professional | 54 · Surgery only | $177.83 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $35.48 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $23.99 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $245.47 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $165.96 | $245.47 | $281.84 |
Where Kentucky sits
The same service costs 4.1 times more in New York than in Maryland. 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
NY $3,010MD $740
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.