How much rates vary
Facilitymedian $2,754 · 10th to 90th $631 to $8,913Professionalmedian $501 · 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 $478.63 Median $616.60 Typical High $3,235.94 | Facility | None | $478.63 | $616.60 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $812.83 | Professional | None | $436.52 | $549.54 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $794.33 | Professional | None | $288.40 | $501.19 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,071.52 | $3,311.31 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $691.83 | Professional | None | $354.81 | $436.52 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $275.42 Typical High $436.52 | Professional | 62 · Two surgeons | $223.87 | $275.42 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $831.76 Typical High $7,585.78 | Facility | None | $436.52 | $831.76 | $7,585.78 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $851.14 | Professional | None | $467.74 | $691.83 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $5,754.40 | Facility | None | $933.25 | $2,290.87 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $3,311.31 | Professional | None | $501.19 | $660.69 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $229.09 | Professional | None | $33.11 | $33.11 | $229.09 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $954.99 | Professional | None | $501.19 | $616.60 | $954.99 |
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 $239.88 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $95.50 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $407.38 Typical High $467.74 | Professional | 54 · Surgery only | $354.81 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $93.33 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $380.19 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $331.13 | $380.19 | $436.52 |
Where Kentucky sits
The same service costs 7.5 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 $13,659MT $1,825
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.