How much rates vary
Facilitymedian $1,318 · 10th to 90th $209 to $2,884Professionalmedian $263 · 10th to 90th $95 to $501
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 $125.89 Median $398.11 Typical High $851.14 | Facility | None | $125.89 | $398.11 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $309.03 Typical High $501.19 | Professional | None | $125.89 | $309.03 | $501.19 |
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 $95.50 Median $257.04 Typical High $371.54 | Professional | None | $95.50 | $257.04 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $2,344.23 | Facility | None | $117.49 | $190.55 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $194.98 | Professional | None | $107.15 | $147.91 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $1,318.26 Typical High $1,698.24 | Facility | None | $208.93 | $1,318.26 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $398.11 Typical High $2,238.72 | Professional | None | $123.03 | $398.11 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $67.61 | Professional | None | $33.11 | $33.11 | $67.61 |
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 $138.04 Median $309.03 Typical High $575.44 | Professional | None | $138.04 | $309.03 | $575.44 |
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 $63.10 Median $154.88 Typical High $251.19 | Facility | 52 · Reduced service | $63.10 | $154.88 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $61.66 Typical High $100.00 | Facility | 53 · Discontinued | $25.12 | $61.66 | $100.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $229.09 Typical High $380.19 | Facility | 54 · Surgery only | $93.33 | $229.09 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $46.77 Typical High $75.86 | Facility | 55 · Aftercare only | $18.62 | $46.77 | $75.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $30.90 Typical High $50.12 | Facility | 56 · Pre-op care only | $12.59 | $30.90 | $50.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $213.80 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $87.10 | $213.80 | $354.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $154.88 Typical High $251.19 | Professional | 52 · Reduced service | $63.10 | $154.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $61.66 Typical High $100.00 | Professional | 53 · Discontinued | $25.12 | $61.66 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $229.09 Typical High $380.19 | Professional | 54 · Surgery only | $93.33 | $229.09 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $46.77 Typical High $75.86 | Professional | 55 · Aftercare only | $18.62 | $46.77 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $30.90 Typical High $50.12 | Professional | 56 · Pre-op care only | $12.59 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $213.80 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $87.10 | $213.80 | $354.81 |
Where Kentucky sits
The same service costs 5.6 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 $4,763ND $853
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.