How much rates vary
Facilitymedian $794 · 10th to 90th $158 to $2,818Professionalmedian $275 · 10th to 90th $204 to $437
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 $245.47 Median $309.03 Typical High $794.33 | Facility | None | $245.47 | $309.03 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $363.08 | Professional | None | $223.87 | $281.84 | $363.08 |
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 $204.17 Median $245.47 Typical High $331.13 | Professional | None | $204.17 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $371.54 Typical High $489.78 | Professional | 50 · Both sides | $309.03 | $371.54 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $263.03 Typical High $323.59 | Facility | None | $173.78 | $263.03 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $446.68 | Professional | None | $245.47 | $354.81 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $398.11 Typical High $1,318.26 | Facility | None | $147.91 | $398.11 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $1,862.09 | Professional | None | $275.42 | $331.13 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $109.65 | Professional | None | $33.11 | $33.11 | $109.65 |
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 $245.47 Median $309.03 Typical High $489.78 | Professional | None | $245.47 | $309.03 | $489.78 |
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 $123.03 Median $151.36 Typical High $177.83 | Facility | 52 · Reduced service | $123.03 | $151.36 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $61.66 Typical High $70.79 | Facility | 53 · Discontinued | $48.98 | $61.66 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $186.21 Median $229.09 Typical High $263.03 | Facility | 54 · Surgery only | $186.21 | $229.09 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $52.48 | Facility | 55 · Aftercare only | $37.15 | $45.71 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.90 Typical High $35.48 | Facility | 56 · Pre-op care only | $24.55 | $30.90 | $35.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $213.80 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $173.78 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $123.03 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $66.07 | Professional | 53 · Discontinued | $48.98 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $229.09 |
Where Kentucky sits
The same service costs 6.5 times more in Connecticut than in Maryland. 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 $3,149MD $483
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.