How much rates vary
Facilitymedian $1,259 · 10th to 90th $186 to $2,884Professionalmedian $148 · 10th to 90th $91 to $251
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 $117.49 Median $194.98 Typical High $851.14 | Facility | None | $117.49 | $194.98 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $251.19 | Professional | None | $117.49 | $186.21 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $181.97 | Professional | None | $81.28 | $134.90 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $177.83 Typical High $2,344.23 | Facility | None | $95.50 | $177.83 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $177.83 | Professional | None | $100.00 | $131.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $1,318.26 Typical High $1,778.28 | Facility | None | $194.98 | $1,318.26 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $1,047.13 | Professional | None | $114.82 | $194.98 | $1,047.13 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $263.03 | Professional | None | $117.49 | $177.83 | $263.03 |
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 $58.88 Median $91.20 Typical High $125.89 | Facility | 52 · Reduced service | $58.88 | $91.20 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $37.15 Typical High $50.12 | Facility | 53 · Discontinued | $23.44 | $37.15 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $186.21 | Facility | 54 · Surgery only | $87.10 | $138.04 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $37.15 | Facility | 55 · Aftercare only | $17.38 | $27.54 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.62 Typical High $25.12 | Facility | 56 · Pre-op care only | $11.75 | $18.62 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $128.82 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $81.28 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $91.20 Typical High $125.89 | Professional | 52 · Reduced service | $58.88 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $37.15 Typical High $50.12 | Professional | 53 · Discontinued | $23.44 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $186.21 | Professional | 54 · Surgery only | $87.10 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $37.15 | Professional | 55 · Aftercare only | $17.38 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.62 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.75 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $128.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $81.28 | $128.82 | $173.78 |
Where Kentucky sits
The same service costs 9.8 times more in Colorado than in North Dakota. 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 $4,589ND $469
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.