How much rates vary
Facilitymedian $1,259 · 10th to 90th $468 to $6,918Professionalmedian $562 · 10th to 90th $437 to $871
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 $436.52 Median $575.44 Typical High $1,000.00 | Facility | None | $436.52 | $575.44 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $933.25 | Professional | None | $436.52 | $549.54 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $794.33 | Professional | None | $489.78 | $660.69 | $794.33 |
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 $407.38 Median $524.81 Typical High $724.44 | Professional | None | $407.38 | $524.81 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $794.33 Typical High $1,071.52 | Professional | 50 · Both sides | $616.60 | $794.33 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $1,412.54 | Facility | None | $467.74 | $758.58 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $794.33 | Professional | None | $436.52 | $645.65 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,862.09 | Facility | None | $912.01 | $1,000.00 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $3,311.31 | Professional | None | $489.78 | $616.60 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $302.00 | Professional | None | $33.11 | $33.11 | $302.00 |
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 $512.86 Median $645.65 Typical High $912.01 | Professional | None | $512.86 | $645.65 | $912.01 |
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 $218.78 Median $275.42 Typical High $316.23 | Facility | 52 · Reduced service | $218.78 | $275.42 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $87.10 Median $109.65 Typical High $125.89 | Facility | 53 · Discontinued | $87.10 | $109.65 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $478.63 | Facility | 54 · Surgery only | $331.13 | $407.38 | $478.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $95.50 | Facility | 55 · Aftercare only | $66.07 | $81.28 | $95.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $43.65 Median $54.95 Typical High $63.10 | Facility | 56 · Pre-op care only | $43.65 | $54.95 | $63.10 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $446.68 | Facility | 78 · Unplanned return to OR | $309.03 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $114.82 | Professional | 53 · Discontinued | $87.10 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $331.13 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $66.07 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $57.54 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $309.03 | $354.81 | $407.38 |
Where Kentucky sits
The same service costs 4.0 times more in Colorado 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
CO $4,440FL $1,118
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.