How much rates vary
Facilitymedian $1,349 · 10th to 90th $447 to $3,890Professionalmedian $372 · 10th to 90th $229 to $676
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 $512.86 Typical High $1,023.29 | Facility | None | $281.84 | $512.86 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $676.08 | Professional | None | $281.84 | $446.68 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $812.83 | Professional | None | $407.38 | $407.38 | $812.83 |
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 $223.87 Median $269.15 Typical High $549.54 | Professional | None | $223.87 | $269.15 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $501.19 Typical High $1,202.26 | Facility | None | $263.03 | $501.19 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $512.86 | Professional | None | $338.84 | $416.87 | $512.86 |
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 $316.23 Median $501.19 Typical High $2,818.38 | Professional | None | $316.23 | $501.19 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $131.83 | Professional | None | $33.11 | $33.11 | $131.83 |
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 $338.84 Median $537.03 Typical High $891.25 | Professional | None | $338.84 | $537.03 | $891.25 |
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 $223.87 Typical High $275.42 | Facility | 52 · Reduced service | $141.25 | $223.87 | $275.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $57.54 Median $89.13 Typical High $109.65 | Facility | 53 · Discontinued | $57.54 | $89.13 | $109.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $213.80 Median $338.84 Typical High $416.87 | Facility | 54 · Surgery only | $213.80 | $338.84 | $416.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $67.61 Typical High $83.18 | Facility | 55 · Aftercare only | $42.66 | $67.61 | $83.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $44.67 Typical High $54.95 | Facility | 56 · Pre-op care only | $28.18 | $44.67 | $54.95 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $316.23 Typical High $389.05 | Facility | 78 · Unplanned return to OR | $199.53 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $218.78 Typical High $275.42 | Professional | 52 · Reduced service | $141.25 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $57.54 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $331.13 Typical High $416.87 | Professional | 54 · Surgery only | $213.80 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $66.07 Typical High $83.18 | Professional | 55 · Aftercare only | $42.66 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $43.65 Typical High $54.95 | Professional | 56 · Pre-op care only | $28.18 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $309.03 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $199.53 | $309.03 | $389.05 |
Where Kentucky sits
The same service costs 4.4 times more in Colorado than in West Virginia. 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 $4,828WV $1,100
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.