How much rates vary
Facilitymedian $1,413 · 10th to 90th $479 to $3,890Professionalmedian $525 · 10th to 90th $407 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 $426.58 Median $524.81 Typical High $851.14 | Facility | None | $426.58 | $524.81 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $691.83 | Professional | None | $426.58 | $501.19 | $691.83 |
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 $398.11 Median $478.63 Typical High $794.33 | Professional | None | $398.11 | $478.63 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $741.31 Typical High $1,174.90 | Professional | 50 · Both sides | $602.56 | $741.31 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $1,412.54 | Facility | None | $446.68 | $741.31 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $758.58 | Professional | None | $457.09 | $630.96 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $977.24 Typical High $1,659.59 | Facility | None | $549.54 | $977.24 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $3,467.37 | Professional | None | $467.74 | $588.84 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $275.42 | Professional | None | $33.11 | $33.11 | $275.42 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $912.01 | Professional | None | $478.63 | $575.44 | $912.01 |
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 $213.80 Median $263.03 Typical High $331.13 | Facility | 52 · Reduced service | $213.80 | $263.03 | $331.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $85.11 Median $104.71 Typical High $131.83 | Facility | 53 · Discontinued | $85.11 | $104.71 | $131.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $316.23 Median $398.11 Typical High $489.78 | Facility | 54 · Surgery only | $316.23 | $398.11 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $64.57 Median $79.43 Typical High $97.72 | Facility | 55 · Aftercare only | $64.57 | $79.43 | $97.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $42.66 Median $52.48 Typical High $66.07 | Facility | 56 · Pre-op care only | $42.66 | $52.48 | $66.07 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $371.54 Typical High $457.09 | Facility | 78 · Unplanned return to OR | $295.12 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $239.88 Typical High $288.40 | Professional | 52 · Reduced service | $213.80 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $117.49 | Professional | 53 · Discontinued | $85.11 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $316.23 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $87.10 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $42.66 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $338.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $295.12 | $338.84 | $407.38 |
Where Kentucky sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.