How much rates vary
Facilitymedian $1,000 · 10th to 90th $158 to $3,802Professionalmedian $501 · 10th to 90th $398 to $794
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 $426.58 Median $524.81 Typical High $851.14 | Facility | None | $426.58 | $524.81 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $537.03 | Professional | None | $426.58 | $489.78 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $758.58 | Professional | None | $398.11 | $467.74 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $707.95 Typical High $1,122.02 | Professional | 50 · Both sides | $602.56 | $707.95 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $398.11 Typical High $537.03 | Facility | None | $173.78 | $398.11 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $758.58 | Professional | None | $426.58 | $630.96 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $524.81 Typical High $1,659.59 | Facility | None | $147.91 | $524.81 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $3,981.07 | Professional | None | $478.63 | $588.84 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $251.19 | Professional | None | $33.11 | $33.11 | $251.19 |
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 $457.09 Median $575.44 Typical High $870.96 | Professional | None | $457.09 | $575.44 | $870.96 |
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 $213.80 Median $263.03 Typical High $371.54 | Facility | 52 · Reduced service | $213.80 | $263.03 | $371.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $85.11 Median $104.71 Typical High $151.36 | Facility | 53 · Discontinued | $85.11 | $104.71 | $151.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $323.59 Median $398.11 Typical High $562.34 | Facility | 54 · Surgery only | $323.59 | $398.11 | $562.34 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $64.57 Median $79.43 Typical High $112.20 | Facility | 55 · Aftercare only | $64.57 | $79.43 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $42.66 Median $52.48 Typical High $74.13 | Facility | 56 · Pre-op care only | $42.66 | $52.48 | $74.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $371.54 Typical High $524.81 | Facility | 78 · Unplanned return to OR | $302.00 | $371.54 | $524.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $213.80 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $85.11 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $323.59 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $42.66 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $302.00 | $338.84 | $371.54 |
Where Kentucky sits
The same service costs 5.2 times more in Connecticut 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
CT $3,486FL $668
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.