How much rates vary
Facilitymedian $1,660 · 10th to 90th $380 to $6,918Professionalmedian $347 · 10th to 90th $219 to $603
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 $263.03 Median $467.74 Typical High $831.76 | Facility | None | $263.03 | $467.74 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $562.34 | Professional | None | $263.03 | $380.19 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $436.52 | Professional | None | $281.84 | $436.52 | $436.52 |
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 $208.93 Median $257.04 Typical High $588.84 | Professional | None | $208.93 | $257.04 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $380.19 Typical High $870.96 | Professional | 50 · Both sides | $316.23 | $380.19 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,412.54 | Facility | None | $281.84 | $457.09 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $467.74 | Professional | None | $281.84 | $389.05 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,862.09 | Facility | None | $512.86 | $1,000.00 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $2,951.21 | Professional | None | $295.12 | $426.58 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $165.96 | Professional | None | $33.11 | $33.11 | $165.96 |
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 $316.23 Median $436.52 Typical High $645.65 | Professional | None | $316.23 | $436.52 | $645.65 |
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 $131.83 Median $190.55 Typical High $275.42 | Facility | 52 · Reduced service | $131.83 | $190.55 | $275.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $52.48 Median $75.86 Typical High $112.20 | Facility | 53 · Discontinued | $52.48 | $75.86 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $288.40 Typical High $416.87 | Facility | 54 · Surgery only | $199.53 | $288.40 | $416.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $57.54 Typical High $83.18 | Facility | 55 · Aftercare only | $39.81 | $57.54 | $83.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.02 Typical High $54.95 | Facility | 56 · Pre-op care only | $26.30 | $38.02 | $54.95 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $269.15 Typical High $389.05 | Facility | 78 · Unplanned return to OR | $186.21 | $269.15 | $389.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $190.55 Typical High $234.42 | Professional | 52 · Reduced service | $131.83 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $75.86 Typical High $93.33 | Professional | 53 · Discontinued | $52.48 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $288.40 Typical High $354.81 | Professional | 54 · Surgery only | $199.53 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $57.54 Typical High $70.79 | Professional | 55 · Aftercare only | $39.81 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.02 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.30 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $269.15 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $186.21 | $269.15 | $331.13 |
Where Kentucky sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $4,833WV $936
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.