How much rates vary
Facilitymedian $295 · 10th to 90th $87 to $1,380Professionalmedian $282 · 10th to 90th $204 to $437
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 $239.88 Median $295.12 Typical High $512.86 | Facility | None | $239.88 | $295.12 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $363.08 | Professional | None | $239.88 | $281.84 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $323.59 | Professional | None | $204.17 | $251.19 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $257.04 Typical High $323.59 | Facility | None | $173.78 | $257.04 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $416.87 | Professional | None | $263.03 | $338.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $512.86 | Facility | None | $34.67 | $154.88 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $1,905.46 | Professional | None | $263.03 | $331.13 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $93.33 | Professional | None | $33.11 | $33.11 | $93.33 |
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 $251.19 Median $323.59 Typical High $501.19 | Professional | None | $251.19 | $323.59 | $501.19 |
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 $120.23 Median $147.91 Typical High $181.97 | Facility | 52 · Reduced service | $120.23 | $147.91 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $72.44 | Facility | 53 · Discontinued | $47.86 | $58.88 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $181.97 Median $223.87 Typical High $275.42 | Facility | 54 · Surgery only | $181.97 | $223.87 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $36.31 Median $44.67 Typical High $54.95 | Facility | 55 · Aftercare only | $36.31 | $44.67 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $36.31 | Facility | 56 · Pre-op care only | $23.99 | $29.51 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $208.93 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $169.82 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $138.04 Typical High $173.78 | Professional | 52 · Reduced service | $120.23 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $69.18 | Professional | 53 · Discontinued | $47.86 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $208.93 Typical High $257.04 | Professional | 54 · Surgery only | $181.97 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $41.69 Typical High $51.29 | Professional | 55 · Aftercare only | $36.31 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $194.98 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $169.82 | $194.98 | $239.88 |
Where Kentucky sits
The same service costs 6.7 times more in New York 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
NY $2,828FL $419
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.