How much rates vary
Facilitymedian $1,862 · 10th to 90th $398 to $7,244Professionalmedian $347 · 10th to 90th $219 to $676
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 $269.15 Median $398.11 Typical High $851.14 | Facility | None | $269.15 | $398.11 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $489.78 | Professional | None | $269.15 | $371.54 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $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 $213.80 Median $257.04 Typical High $676.08 | Professional | None | $213.80 | $257.04 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $389.05 Typical High $1,023.29 | Professional | 50 · Both sides | $323.59 | $389.05 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $134.90 Median $162.18 Typical High $426.58 | Professional | 62 · Two surgeons | $134.90 | $162.18 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $467.74 Typical High $2,691.53 | Facility | None | $288.40 | $467.74 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $478.63 | Professional | None | $263.03 | $380.19 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $1,995.26 | Facility | None | $512.86 | $1,819.70 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $3,162.28 | Professional | None | $295.12 | $446.68 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $186.21 | Professional | None | $33.11 | $33.11 | $186.21 |
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 $323.59 Median $467.74 Typical High $676.08 | Professional | None | $323.59 | $467.74 | $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 $134.90 Median $194.98 Typical High $295.12 | Facility | 52 · Reduced service | $134.90 | $194.98 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $79.43 Typical High $117.49 | Facility | 53 · Discontinued | $53.70 | $79.43 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $295.12 Typical High $446.68 | Facility | 54 · Surgery only | $199.53 | $295.12 | $446.68 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $58.88 Typical High $89.13 | Facility | 55 · Aftercare only | $39.81 | $58.88 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $39.81 Typical High $58.88 | Facility | 56 · Pre-op care only | $26.92 | $39.81 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $275.42 Typical High $416.87 | Facility | 78 · Unplanned return to OR | $186.21 | $275.42 | $416.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $194.98 Typical High $245.47 | Professional | 52 · Reduced service | $134.90 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $79.43 Typical High $97.72 | Professional | 53 · Discontinued | $53.70 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $295.12 Typical High $363.08 | Professional | 54 · Surgery only | $199.53 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $58.88 Typical High $72.44 | Professional | 55 · Aftercare only | $39.81 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $39.81 Typical High $48.98 | Professional | 56 · Pre-op care only | $26.92 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $275.42 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $186.21 | $275.42 | $338.84 |
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 $1,193
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.