How much rates vary
Facilitymedian $1,862 · 10th to 90th $407 to $7,244Professionalmedian $363 · 10th to 90th $224 to $617
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 $501.19 Typical High $870.96 | Facility | None | $281.84 | $501.19 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $575.44 | Professional | None | $281.84 | $371.54 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $263.03 Typical High $562.34 | Professional | None | $213.80 | $263.03 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $134.90 Median $165.96 Typical High $354.81 | Professional | 62 · Two surgeons | $134.90 | $165.96 | $354.81 |
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 $1,862.09 Typical High $1,995.26 | Facility | None | $549.54 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $3,090.30 | Professional | None | $309.03 | $457.09 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $218.78 | Professional | None | $33.11 | $33.11 | $218.78 |
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 $323.59 Median $457.09 Typical High $676.08 | Professional | None | $323.59 | $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 $138.04 Median $204.17 Typical High $288.40 | Facility | 52 · Reduced service | $138.04 | $204.17 | $288.40 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $81.28 Typical High $114.82 | Facility | 53 · Discontinued | $56.23 | $81.28 | $114.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $302.00 Typical High $436.52 | Facility | 54 · Surgery only | $208.93 | $302.00 | $436.52 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $60.26 Typical High $87.10 | Facility | 55 · Aftercare only | $41.69 | $60.26 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $40.74 Typical High $57.54 | Facility | 56 · Pre-op care only | $28.18 | $40.74 | $57.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $281.84 Typical High $407.38 | Facility | 78 · Unplanned return to OR | $194.98 | $281.84 | $407.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $138.04 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $81.28 Typical High $100.00 | Professional | 53 · Discontinued | $56.23 | $81.28 | $100.00 |
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 $75.86 | Professional | 55 · Aftercare only | $41.69 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $28.18 | $40.74 | $50.12 |
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 6.4 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 $6,390WV $1,003
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.