How much rates vary
Facilitymedian $1,047 · 10th to 90th $302 to $2,818Professionalmedian $417 · 10th to 90th $302 to $661
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 $363.08 Median $457.09 Typical High $851.14 | Facility | None | $363.08 | $457.09 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $524.81 | Professional | None | $363.08 | $416.87 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $588.84 | Professional | None | $302.00 | $363.08 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $549.54 Typical High $870.96 | Professional | 50 · Both sides | $446.68 | $549.54 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $1,412.54 | Facility | None | $389.05 | $630.96 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $660.69 | Professional | None | $436.52 | $537.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $1,318.26 | Facility | None | $416.87 | $977.24 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $2,754.23 | Professional | None | $407.38 | $489.78 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $177.83 | Professional | None | $33.11 | $33.11 | $177.83 |
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 $354.81 Median $457.09 Typical High $741.31 | Professional | None | $354.81 | $457.09 | $741.31 |
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 $181.97 Median $223.87 Typical High $263.03 | Facility | 52 · Reduced service | $181.97 | $223.87 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $72.44 Median $91.20 Typical High $104.71 | Facility | 53 · Discontinued | $72.44 | $91.20 | $104.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $275.42 Median $338.84 Typical High $389.05 | Facility | 54 · Surgery only | $275.42 | $338.84 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $54.95 Median $67.61 Typical High $77.62 | Facility | 55 · Aftercare only | $54.95 | $67.61 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $52.48 | Facility | 56 · Pre-op care only | $36.31 | $45.71 | $52.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $316.23 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $257.04 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $181.97 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $72.44 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $275.42 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $36.31 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $257.04 | $295.12 | $346.74 |
Where Kentucky sits
The same service costs 5.3 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 $4,377FL $831
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.