How much rates vary
Facilitymedian $1,479 · 10th to 90th $479 to $4,169Professionalmedian $468 · 10th to 90th $347 to $813
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 $354.81 Median $478.63 Typical High $851.14 | Facility | None | $354.81 | $478.63 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $588.84 | Professional | None | $354.81 | $436.52 | $588.84 |
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 $331.13 Median $407.38 Typical High $812.83 | Professional | None | $331.13 | $407.38 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $616.60 Typical High $1,202.26 | Professional | 50 · Both sides | $501.19 | $616.60 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $2,041.74 | Facility | None | $371.54 | $616.60 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $616.60 | Professional | None | $346.74 | $501.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,412.54 Typical High $1,659.59 | Facility | None | $489.78 | $1,412.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $3,890.45 | Professional | None | $398.11 | $549.54 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $173.78 | Professional | None | $33.11 | $33.11 | $173.78 |
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 $407.38 Median $562.34 Typical High $831.76 | Professional | None | $407.38 | $562.34 | $831.76 |
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 $173.78 Median $239.88 Typical High $363.08 | Facility | 52 · Reduced service | $173.78 | $239.88 | $363.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $95.50 Typical High $144.54 | Facility | 53 · Discontinued | $70.79 | $95.50 | $144.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $363.08 Typical High $549.54 | Facility | 54 · Surgery only | $263.03 | $363.08 | $549.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $72.44 Typical High $109.65 | Facility | 55 · Aftercare only | $52.48 | $72.44 | $109.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $47.86 Typical High $72.44 | Facility | 56 · Pre-op care only | $35.48 | $47.86 | $72.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $338.84 Typical High $512.86 | Facility | 78 · Unplanned return to OR | $245.47 | $338.84 | $512.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $173.78 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $95.50 Typical High $120.23 | Professional | 53 · Discontinued | $70.79 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $363.08 Typical High $446.68 | Professional | 54 · Surgery only | $263.03 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $72.44 Typical High $89.13 | Professional | 55 · Aftercare only | $52.48 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $35.48 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $338.84 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $245.47 | $338.84 | $416.87 |
Where Kentucky sits
The same service costs 4.4 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 $6,491MT $1,489
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.