How much rates vary
Facilitymedian $1,660 · 10th to 90th $447 to $4,169Professionalmedian $407 · 10th to 90th $316 to $661
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 $398.11 Median $436.52 Typical High $5,248.07 | Facility | None | $398.11 | $436.52 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $724.44 | Professional | None | $436.52 | $436.52 | $724.44 |
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 $302.00 Median $371.54 Typical High $549.54 | Professional | None | $302.00 | $371.54 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $549.54 Typical High $831.76 | Professional | 50 · Both sides | $457.09 | $549.54 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $660.69 Typical High $2,344.23 | Facility | None | $416.87 | $660.69 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $691.83 | Professional | None | $380.19 | $588.84 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,621.81 Typical High $1,778.28 | Facility | None | $524.81 | $1,621.81 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $2,089.30 | Professional | None | $426.58 | $575.44 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $380.19 Median $501.19 Typical High $794.33 | Professional | None | $380.19 | $501.19 | $794.33 |
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 $213.80 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $213.80 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $87.10 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $323.59 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $309.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $302.00 | $309.03 | $363.08 |
Where Kentucky sits
The same service costs 3.6 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 $5,175MT $1,450
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.