How much rates vary
Facilitymedian $1,445 · 10th to 90th $479 to $3,890Professionalmedian $417 · 10th to 90th $309 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 $389.05 Median $489.78 Typical High $954.99 | Facility | None | $389.05 | $489.78 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $776.25 | Professional | None | $389.05 | $478.63 | $776.25 |
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 $309.03 Median $380.19 Typical High $562.34 | Professional | None | $309.03 | $380.19 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $575.44 Typical High $831.76 | Professional | 50 · Both sides | $467.74 | $575.44 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $2,570.40 | Facility | None | $371.54 | $616.60 | $2,570.40 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $645.65 | Professional | None | $426.58 | $537.03 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $1,905.46 | Facility | None | $660.69 | $1,659.59 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $2,818.38 | Professional | None | $398.11 | $575.44 | $2,818.38 |
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 $389.05 Median $524.81 Typical High $831.76 | Professional | None | $389.05 | $524.81 | $831.76 |
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 $194.98 Median $239.88 Typical High $269.15 | Facility | 52 · Reduced service | $194.98 | $239.88 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $77.62 Median $97.72 Typical High $107.15 | Facility | 53 · Discontinued | $77.62 | $97.72 | $107.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $295.12 Median $363.08 Typical High $398.11 | Facility | 54 · Surgery only | $295.12 | $363.08 | $398.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $58.88 Median $72.44 Typical High $79.43 | Facility | 55 · Aftercare only | $58.88 | $72.44 | $79.43 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.90 Median $47.86 Typical High $53.70 | Facility | 56 · Pre-op care only | $38.90 | $47.86 | $53.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $338.84 Typical High $371.54 | Facility | 78 · Unplanned return to OR | $275.42 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $194.98 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $77.62 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $295.12 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $38.90 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $371.54 |
Where Kentucky sits
The same service costs 5.4 times more in Wisconsin than in West Virginia. 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
WI $6,411WV $1,178
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.