How much rates vary
Facilitymedian $1,905 · 10th to 90th $447 to $7,244Professionalmedian $427 · 10th to 90th $309 to $776
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 $309.03 Median $446.68 Typical High $851.14 | Facility | None | $309.03 | $446.68 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $562.34 | Professional | None | $309.03 | $416.87 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $776.25 | Professional | None | $295.12 | $371.54 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $562.34 Typical High $1,148.15 | Professional | 50 · Both sides | $446.68 | $562.34 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $2,691.53 | Facility | None | $331.13 | $537.03 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $537.03 | Professional | None | $302.00 | $436.52 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $1,995.26 | Facility | None | $602.56 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $3,630.78 | Professional | None | $338.84 | $512.86 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $181.97 | Professional | None | $33.11 | $33.11 | $181.97 |
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 $363.08 Median $524.81 Typical High $776.25 | Professional | None | $363.08 | $524.81 | $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 $154.88 Median $223.87 Typical High $338.84 | Facility | 52 · Reduced service | $154.88 | $223.87 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $134.90 | Facility | 53 · Discontinued | $61.66 | $89.13 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $229.09 Median $331.13 Typical High $512.86 | Facility | 54 · Surgery only | $229.09 | $331.13 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $45.71 Median $66.07 Typical High $102.33 | Facility | 55 · Aftercare only | $45.71 | $66.07 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $67.61 | Facility | 56 · Pre-op care only | $30.90 | $44.67 | $67.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $309.03 Typical High $478.63 | Facility | 78 · Unplanned return to OR | $213.80 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $154.88 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $109.65 | Professional | 53 · Discontinued | $61.66 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $331.13 Typical High $416.87 | Professional | 54 · Surgery only | $229.09 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $66.07 Typical High $83.18 | Professional | 55 · Aftercare only | $45.71 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $309.03 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $213.80 | $309.03 | $389.05 |
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 $6,438MT $1,383
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.