How much rates vary
Facilitymedian $1,288 · 10th to 90th $380 to $3,890Professionalmedian $417 · 10th to 90th $309 to $631
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 $346.74 Median $426.58 Typical High $851.14 | Facility | None | $346.74 | $426.58 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $512.86 | Professional | None | $346.74 | $398.11 | $512.86 |
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 $309.03 Median $380.19 Typical High $602.56 | Professional | None | $309.03 | $380.19 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $562.34 Typical High $912.01 | Professional | 50 · Both sides | $467.74 | $562.34 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $1,412.54 | Facility | None | $371.54 | $602.56 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $616.60 | Professional | None | $416.87 | $512.86 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,659.59 | Facility | None | $707.95 | $1,000.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $2,884.03 | Professional | None | $380.19 | $467.74 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $173.78 | Professional | None | $33.11 | $33.11 | $173.78 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $724.44 | Professional | None | $354.81 | $446.68 | $724.44 |
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 $173.78 Median $213.80 Typical High $269.15 | Facility | 52 · Reduced service | $173.78 | $213.80 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $85.11 Typical High $107.15 | Facility | 53 · Discontinued | $69.18 | $85.11 | $107.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $323.59 Typical High $407.38 | Facility | 54 · Surgery only | $257.04 | $323.59 | $407.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $64.57 Typical High $81.28 | Facility | 55 · Aftercare only | $51.29 | $64.57 | $81.28 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $53.70 | Facility | 56 · Pre-op care only | $34.67 | $42.66 | $53.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $302.00 Typical High $380.19 | Facility | 78 · Unplanned return to OR | $239.88 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $199.53 Typical High $234.42 | Professional | 52 · Reduced service | $173.78 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $93.33 | Professional | 53 · Discontinued | $69.18 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $257.04 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $69.18 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $46.77 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $275.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $239.88 | $275.42 | $323.59 |
Where Kentucky sits
The same service costs 4.5 times more in Vermont than in Florida. 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
VT $4,521FL $1,007
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.