How much rates vary
Facilitymedian $832 · 10th to 90th $158 to $2,818Professionalmedian $457 · 10th to 90th $347 to $692
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 $389.05 Median $478.63 Typical High $851.14 | Facility | None | $389.05 | $478.63 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $562.34 | Professional | None | $389.05 | $446.68 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $549.54 | Professional | None | $346.74 | $416.87 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $630.96 Typical High $831.76 | Professional | 50 · Both sides | $524.81 | $630.96 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $354.81 Typical High $478.63 | Facility | None | $173.78 | $354.81 | $478.63 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $691.83 | Professional | None | $416.87 | $562.34 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $512.86 Typical High $1,318.26 | Facility | None | $147.91 | $512.86 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $2,951.21 | Professional | None | $426.58 | $524.81 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $186.21 | Professional | None | $33.11 | $33.11 | $186.21 |
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 $398.11 Median $501.19 Typical High $812.83 | Professional | None | $398.11 | $501.19 | $812.83 |
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 $194.98 Median $239.88 Typical High $281.84 | Facility | 52 · Reduced service | $194.98 | $239.88 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $77.62 Median $95.50 Typical High $112.20 | Facility | 53 · Discontinued | $77.62 | $95.50 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $288.40 Median $363.08 Typical High $416.87 | Facility | 54 · Surgery only | $288.40 | $363.08 | $416.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $57.54 Median $72.44 Typical High $85.11 | Facility | 55 · Aftercare only | $57.54 | $72.44 | $85.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.90 Median $47.86 Typical High $56.23 | Facility | 56 · Pre-op care only | $38.90 | $47.86 | $56.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $338.84 Typical High $389.05 | Facility | 78 · Unplanned return to OR | $269.15 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $194.98 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $288.40 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $309.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $269.15 | $309.03 | $363.08 |
Where Kentucky sits
The same service costs 4.9 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 $3,107FL $640
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.