How much rates vary
Facilitymedian $3,090 · 10th to 90th $437 to $10,233Professionalmedian $4,365 · 10th to 90th $398 to $8,710
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 $436.52 Median $1,621.81 Typical High $10,232.93 | Facility | None | $436.52 | $1,621.81 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $2,818.38 Typical High $6,456.54 | Professional | None | $436.52 | $2,818.38 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,120.11 Typical High $11,220.18 | Facility | None | $758.58 | $9,120.11 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $4,365.16 Typical High $6,918.31 | Professional | None | $398.11 | $4,365.16 | $6,918.31 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $660.69 Typical High $12,022.64 | Facility | None | $407.38 | $660.69 | $12,022.64 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $660.69 | Professional | None | $416.87 | $524.81 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $9,120.11 | Facility | None | $34.67 | $831.76 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $5,128.61 Typical High $29,512.09 | Professional | None | $416.87 | $5,128.61 | $29,512.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $302.00 | Professional | None | $33.11 | $33.11 | $302.00 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $537.03 Median $5,248.07 Typical High $11,220.18 | Professional | None | $537.03 | $5,248.07 | $11,220.18 |
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 $218.78 Median $363.08 Typical High $5,128.61 | Facility | 52 · Reduced service | $218.78 | $363.08 | $5,128.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $87.10 Median $144.54 Typical High $2,089.30 | Facility | 53 · Discontinued | $87.10 | $144.54 | $2,089.30 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $331.13 Median $537.03 Typical High $7,762.47 | Facility | 54 · Surgery only | $331.13 | $537.03 | $7,762.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $66.07 Median $107.15 Typical High $1,548.82 | Facility | 55 · Aftercare only | $66.07 | $107.15 | $1,548.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $43.65 Median $72.44 Typical High $1,023.29 | Facility | 56 · Pre-op care only | $43.65 | $72.44 | $1,023.29 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $501.19 Typical High $7,244.36 | Facility | 78 · Unplanned return to OR | $309.03 | $501.19 | $7,244.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $2,511.89 Typical High $3,235.94 | Professional | 52 · Reduced service | $218.78 | $2,511.89 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $1,023.29 Typical High $1,288.25 | Professional | 53 · Discontinued | $87.10 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $3,801.89 Typical High $4,786.30 | Professional | 54 · Surgery only | $331.13 | $3,801.89 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $758.58 Typical High $954.99 | Professional | 55 · Aftercare only | $66.07 | $758.58 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $512.86 Typical High $645.65 | Professional | 56 · Pre-op care only | $43.65 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $3,548.13 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $309.03 | $3,548.13 | $4,466.84 |
Where Kentucky sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.