How much rates vary
Facilitymedian $1,479 · 10th to 90th $427 to $4,169Professionalmedian $437 · 10th to 90th $316 to $933
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 $331.13 Median $426.58 Typical High $912.01 | Facility | None | $331.13 | $426.58 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $602.56 | Professional | None | $331.13 | $416.87 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $316.23 Median $380.19 Typical High $933.25 | Professional | None | $316.23 | $380.19 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $575.44 Typical High $1,380.38 | Professional | 50 · Both sides | $467.74 | $575.44 | $1,380.38 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $575.44 Typical High $2,041.74 | Facility | None | $346.74 | $575.44 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $588.84 | Professional | None | $354.81 | $478.63 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $1,659.59 | Facility | None | $645.65 | $1,445.44 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $4,786.30 | Professional | None | $371.54 | $524.81 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $158.49 | Professional | None | $33.11 | $33.11 | $158.49 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $776.25 | Professional | None | $371.54 | $537.03 | $776.25 |
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 $165.96 Median $213.80 Typical High $446.68 | Facility | 52 · Reduced service | $165.96 | $213.80 | $446.68 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $181.97 | Facility | 53 · Discontinued | $66.07 | $85.11 | $181.97 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $676.08 | Facility | 54 · Surgery only | $245.47 | $323.59 | $676.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $134.90 | Facility | 55 · Aftercare only | $48.98 | $64.57 | $134.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $91.20 | Facility | 56 · Pre-op care only | $33.11 | $42.66 | $91.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $630.96 | Facility | 78 · Unplanned return to OR | $229.09 | $302.00 | $630.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $213.80 Typical High $269.15 | Professional | 52 · Reduced service | $165.96 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $66.07 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $245.47 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $53.70 | Professional | 56 · Pre-op care only | $33.11 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $371.54 |
Where Kentucky sits
The same service costs 4.7 times more in Colorado than in Montana. 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 $6,464MT $1,390
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.