How much rates vary
Facilitymedian $1,380 · 10th to 90th $501 to $3,890Professionalmedian $692 · 10th to 90th $562 to $1,047
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 $602.56 Median $741.31 Typical High $5,248.07 | Facility | None | $602.56 | $741.31 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $851.14 | Professional | None | $602.56 | $691.83 | $851.14 |
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 $562.34 Median $660.69 Typical High $933.25 | Professional | None | $562.34 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,000.00 Typical High $1,412.54 | Professional | 50 · Both sides | $851.14 | $1,000.00 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $1,202.26 | Facility | None | $630.96 | $912.01 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,047.13 | Professional | None | $602.56 | $851.14 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $912.01 Typical High $1,659.59 | Facility | None | $776.25 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $4,466.84 | Professional | None | $676.08 | $831.76 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $275.42 | Professional | None | $33.11 | $33.11 | $275.42 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,230.27 | Professional | None | $645.65 | $794.33 | $1,230.27 |
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 $302.00 Median $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $562.34 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 51 · Multiple procedures | $512.86 | $512.86 | $512.86 |
Where Kentucky sits
The same service costs 3.6 times more in Colorado than in Delaware. 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 $4,868DE $1,354
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.