How much rates vary
Facilitymedian $1,660 · 10th to 90th $398 to $4,169Professionalmedian $363 · 10th to 90th $229 to $631
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 $281.84 Median $398.11 Typical High $851.14 | Facility | None | $281.84 | $398.11 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $489.78 | Professional | None | $281.84 | $371.54 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $223.87 Median $269.15 Typical High $616.60 | Professional | None | $223.87 | $269.15 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $2,691.53 | Facility | None | $302.00 | $489.78 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $501.19 | Professional | None | $302.00 | $407.38 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,659.59 Typical High $1,949.84 | Facility | None | $549.54 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $2,951.21 | Professional | None | $309.03 | $457.09 | $2,951.21 |
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 $338.84 Median $457.09 Typical High $676.08 | Professional | None | $338.84 | $457.09 | $676.08 |
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 $141.25 Median $199.53 Typical High $281.84 | Facility | 52 · Reduced service | $141.25 | $199.53 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $79.43 Typical High $112.20 | Facility | 53 · Discontinued | $56.23 | $79.43 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $302.00 Typical High $416.87 | Facility | 54 · Surgery only | $208.93 | $302.00 | $416.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $60.26 Typical High $83.18 | Facility | 55 · Aftercare only | $41.69 | $60.26 | $83.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $39.81 Typical High $56.23 | Facility | 56 · Pre-op care only | $28.18 | $39.81 | $56.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $281.84 Typical High $389.05 | Facility | 78 · Unplanned return to OR | $194.98 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $199.53 Typical High $245.47 | Professional | 52 · Reduced service | $141.25 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $79.43 Typical High $97.72 | Professional | 53 · Discontinued | $56.23 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $302.00 Typical High $371.54 | Professional | 54 · Surgery only | $208.93 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $60.26 Typical High $74.13 | Professional | 55 · Aftercare only | $41.69 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $39.81 Typical High $48.98 | Professional | 56 · Pre-op care only | $28.18 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $281.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $194.98 | $281.84 | $346.74 |
Where Kentucky sits
The same service costs 5.3 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 $6,378MT $1,213
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.