How much rates vary
Facilitymedian $1,660 · 10th to 90th $603 to $4,365Professionalmedian $513 · 10th to 90th $355 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 $501.19 Median $616.60 Typical High $5,248.07 | Facility | None | $501.19 | $616.60 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $676.08 | Professional | None | $489.78 | $575.44 | $676.08 |
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 $354.81 Median $416.87 Typical High $794.33 | Professional | None | $354.81 | $416.87 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $630.96 Typical High $1,174.90 | Professional | 50 · Both sides | $537.03 | $630.96 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $5,888.44 | Facility | None | $537.03 | $870.96 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $891.25 | Professional | None | $537.03 | $741.31 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $4,365.16 | Facility | None | $588.84 | $1,659.59 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $3,548.13 | Professional | None | $537.03 | $660.69 | $3,548.13 |
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 $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 $489.78 Median $602.56 Typical High $933.25 | Professional | None | $489.78 | $602.56 | $933.25 |
6 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 Professional Modifier 52 · Reduced service Typical Low $245.47 Median $288.40 Typical High $338.84 | Professional | 52 · Reduced service | $245.47 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $114.82 Typical High $134.90 | Professional | 53 · Discontinued | $97.72 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $512.86 | Professional | 54 · Surgery only | $371.54 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $57.54 Typical High $67.61 | Professional | 56 · Pre-op care only | $48.98 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $478.63 |
Where Kentucky sits
The same service costs 5.8 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 $10,794MT $1,867
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.