How much rates vary
Facilitymedian $1,660 · 10th to 90th $288 to $4,266Professionalmedian $479 · 10th to 90th $182 to $1,122
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 $181.97 Median $707.95 Typical High $1,071.52 | Facility | None | $181.97 | $707.95 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $707.95 Typical High $1,288.25 | Professional | None | $181.97 | $707.95 | $1,288.25 |
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 $177.83 Median $467.74 Typical High $912.01 | Professional | None | $177.83 | $467.74 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $269.15 Typical High $3,388.44 | Facility | None | $141.25 | $269.15 | $3,388.44 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $275.42 | Professional | None | $162.18 | $234.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $1,659.59 Typical High $2,454.71 | Facility | None | $288.40 | $1,659.59 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $831.76 Typical High $3,801.89 | Professional | None | $208.93 | $831.76 | $3,801.89 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $251.19 Median $616.60 Typical High $1,380.38 | Professional | None | $251.19 | $616.60 | $1,380.38 |
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 $91.20 Median $134.90 Typical High $467.74 | Facility | 52 · Reduced service | $91.20 | $134.90 | $467.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $53.70 Typical High $186.21 | Facility | 53 · Discontinued | $37.15 | $53.70 | $186.21 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $199.53 Typical High $707.95 | Facility | 54 · Surgery only | $138.04 | $199.53 | $707.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $40.74 Typical High $141.25 | Facility | 55 · Aftercare only | $27.54 | $40.74 | $141.25 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.92 Typical High $93.33 | Facility | 56 · Pre-op care only | $18.20 | $26.92 | $93.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $186.21 Typical High $660.69 | Facility | 78 · Unplanned return to OR | $128.82 | $186.21 | $660.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $302.00 Typical High $467.74 | Professional | 52 · Reduced service | $91.20 | $302.00 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $120.23 Typical High $186.21 | Professional | 53 · Discontinued | $37.15 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $457.09 Typical High $707.95 | Professional | 54 · Surgery only | $138.04 | $457.09 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $91.20 Typical High $141.25 | Professional | 55 · Aftercare only | $27.54 | $91.20 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $60.26 Typical High $93.33 | Professional | 56 · Pre-op care only | $18.20 | $60.26 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $426.58 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $128.82 | $426.58 | $660.69 |
Where Kentucky sits
The same service costs 5.1 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 $7,315MT $1,443
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.