How much rates vary
Facilitymedian $1,413 · 10th to 90th $447 to $3,981Professionalmedian $309 · 10th to 90th $240 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 $275.42 Median $346.74 Typical High $5,248.07 | Facility | None | $275.42 | $346.74 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $524.81 | Professional | None | $275.42 | $316.23 | $524.81 |
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 $239.88 Median $288.40 Typical High $660.69 | Professional | None | $239.88 | $288.40 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $436.52 Typical High $1,000.00 | Professional | 50 · Both sides | $354.81 | $436.52 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $1,412.54 | Facility | None | $295.12 | $478.63 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $501.19 | Professional | None | $331.13 | $407.38 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,659.59 | Facility | None | $537.03 | $1,000.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $3,548.13 | Professional | None | $302.00 | $380.19 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $144.54 | Professional | None | $33.11 | $33.11 | $144.54 |
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 $269.15 Median $346.74 Typical High $562.34 | Professional | None | $269.15 | $346.74 | $562.34 |
7 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 Professional Modifier 52 · Reduced service Typical Low $138.04 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $138.04 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $63.10 Typical High $83.18 | Professional | 53 · Discontinued | $54.95 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $309.03 | Professional | 54 · Surgery only | $208.93 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $47.86 Typical High $61.66 | Professional | 55 · Aftercare only | $41.69 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $40.74 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $223.87 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $194.98 | $223.87 | $288.40 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 51 · Multiple procedures | $223.87 | $223.87 | $223.87 |
Where Kentucky sits
The same service costs 4.6 times more in Colorado than in Montana. 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 $4,822MT $1,050
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.