How much rates vary
Facilitymedian $891 · 10th to 90th $158 to $2,818Professionalmedian $490 · 10th to 90th $363 to $741
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 $407.38 Median $501.19 Typical High $851.14 | Facility | None | $407.38 | $501.19 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $549.54 | Professional | None | $407.38 | $467.74 | $549.54 |
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 $363.08 Median $436.52 Typical High $676.08 | Professional | None | $363.08 | $436.52 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $660.69 Typical High $1,000.00 | Professional | 50 · Both sides | $549.54 | $660.69 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $371.54 Typical High $501.19 | Facility | None | $173.78 | $371.54 | $501.19 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $724.44 | Professional | None | $489.78 | $588.84 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $537.03 Typical High $1,318.26 | Facility | None | $147.91 | $537.03 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $3,162.28 | Professional | None | $446.68 | $562.34 | $3,162.28 |
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 $426.58 Median $524.81 Typical High $851.14 | Professional | None | $426.58 | $524.81 | $851.14 |
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 $204.17 Median $251.19 Typical High $302.00 | Facility | 52 · Reduced service | $204.17 | $251.19 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $100.00 Typical High $120.23 | Facility | 53 · Discontinued | $81.28 | $100.00 | $120.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $380.19 Typical High $446.68 | Facility | 54 · Surgery only | $302.00 | $380.19 | $446.68 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $75.86 Typical High $89.13 | Facility | 55 · Aftercare only | $60.26 | $75.86 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $50.12 Typical High $60.26 | Facility | 56 · Pre-op care only | $40.74 | $50.12 | $60.26 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $416.87 | Facility | 78 · Unplanned return to OR | $281.84 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $229.09 Typical High $275.42 | Professional | 52 · Reduced service | $204.17 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $81.28 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $302.00 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $40.74 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $323.59 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $281.84 | $323.59 | $380.19 |
Where Kentucky sits
The same service costs 5.2 times more in Connecticut 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
CT $3,468DE $666
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.