How much rates vary
Facilitymedian $288 · 10th to 90th $89 to $1,148Professionalmedian $257 · 10th to 90th $186 to $407
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 $229.09 Median $288.40 Typical High $489.78 | Facility | None | $229.09 | $288.40 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $371.54 | Professional | None | $199.53 | $263.03 | $371.54 |
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 $186.21 Median $229.09 Typical High $309.03 | Professional | None | $186.21 | $229.09 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $245.47 Typical High $323.59 | Facility | None | $173.78 | $245.47 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $398.11 | Professional | None | $229.09 | $331.13 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $524.81 | Facility | None | $34.67 | $154.88 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $1,862.09 | Professional | None | $257.04 | $302.00 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $83.18 | Professional | None | $33.11 | $33.11 | $83.18 |
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 $223.87 Median $281.84 Typical High $457.09 | Professional | None | $223.87 | $281.84 | $457.09 |
13 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 $114.82 Median $141.25 Typical High $173.78 | Facility | 52 · Reduced service | $114.82 | $141.25 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $57.54 Typical High $69.18 | Facility | 53 · Discontinued | $45.71 | $57.54 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $173.78 Median $213.80 Typical High $263.03 | Facility | 54 · Surgery only | $173.78 | $213.80 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $42.66 Typical High $52.48 | Facility | 55 · Aftercare only | $34.67 | $42.66 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.84 Typical High $34.67 | Facility | 56 · Pre-op care only | $22.91 | $28.84 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $199.53 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $162.18 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $131.83 Typical High $154.88 | Professional | 52 · Reduced service | $114.82 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $45.71 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $173.78 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $218.78 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $269.15 | $269.15 | $269.15 |
Where Kentucky sits
The same service costs 6.4 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 $2,602FL $408
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.