How much rates vary
Facilitymedian $1,413 · 10th to 90th $363 to $3,890Professionalmedian $309 · 10th to 90th $195 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 $416.87 Typical High $851.14 | Facility | None | $281.84 | $416.87 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $524.81 | Professional | None | $281.84 | $407.38 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $707.95 | Professional | None | $407.38 | $549.54 | $707.95 |
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 $194.98 Median $257.04 Typical High $363.08 | Professional | None | $194.98 | $257.04 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $389.05 Typical High $549.54 | Professional | 50 · Both sides | $288.40 | $389.05 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $1,202.26 | Facility | None | $295.12 | $489.78 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $501.19 | Professional | None | $338.84 | $407.38 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $1,659.59 | Facility | None | $489.78 | $831.76 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $2,691.53 | Professional | None | $257.04 | $467.74 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $93.33 | Professional | None | $33.11 | $33.11 | $93.33 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $676.08 | Professional | None | $181.97 | $338.84 | $676.08 |
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 $173.78 Typical High $257.04 | Facility | 52 · Reduced service | $141.25 | $173.78 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $69.18 Typical High $104.71 | Facility | 53 · Discontinued | $56.23 | $69.18 | $104.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $263.03 Typical High $389.05 | Facility | 54 · Surgery only | $208.93 | $263.03 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $77.62 | Facility | 55 · Aftercare only | $41.69 | $52.48 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $52.48 | Facility | 56 · Pre-op care only | $28.18 | $34.67 | $52.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $245.47 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $194.98 | $245.47 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $141.25 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $81.28 Typical High $104.71 | Professional | 53 · Discontinued | $56.23 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $208.93 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $41.69 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $28.18 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $288.40 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $194.98 | $288.40 | $363.08 |
Where Kentucky sits
The same service costs 4.5 times more in Colorado 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
CO $4,866MD $1,088
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.