How much rates vary
Facilitymedian $1,585 · 10th to 90th $245 to $3,890Professionalmedian $324 · 10th to 90th $191 to $724
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 $151.36 Median $302.00 Typical High $851.14 | Facility | None | $151.36 | $302.00 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $489.78 | Professional | None | $151.36 | $281.84 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $218.78 | Professional | None | $194.98 | $194.98 | $218.78 |
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 $257.04 Median $323.59 Typical High $724.44 | Professional | None | $257.04 | $323.59 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $2,691.53 | Facility | None | $162.18 | $263.03 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $275.42 | Professional | None | $165.96 | $223.87 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $1,659.59 Typical High $1,949.84 | Facility | None | $288.40 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $467.74 Typical High $3,311.31 | Professional | None | $169.82 | $467.74 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $144.54 | Professional | None | $33.11 | $33.11 | $144.54 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,230.27 Typical High $3,890.45 | Facility | None | $707.95 | $1,230.27 | $3,890.45 |
United Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $776.25 | Professional | None | $346.74 | $512.86 | $776.25 |
13 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 $75.86 Median $123.03 Typical High $316.23 | Facility | 52 · Reduced service | $75.86 | $123.03 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $48.98 Typical High $125.89 | Facility | 53 · Discontinued | $30.20 | $48.98 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $467.74 | Facility | 54 · Surgery only | $114.82 | $181.97 | $467.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $93.33 | Facility | 55 · Aftercare only | $22.91 | $36.31 | $93.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $24.55 Typical High $63.10 | Facility | 56 · Pre-op care only | $15.14 | $24.55 | $63.10 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $169.82 Typical High $436.52 | Facility | 78 · Unplanned return to OR | $107.15 | $169.82 | $436.52 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $75.86 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $30.20 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $223.87 | Professional | 54 · Surgery only | $114.82 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $22.91 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $15.14 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $169.82 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $107.15 | $169.82 | $208.93 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 58 · Staged procedure | $109.65 | $109.65 | $109.65 |
Where Kentucky sits
The same service costs 6.9 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 $6,243MT $902
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.