How much rates vary
Facilitymedian $1,259 · 10th to 90th $129 to $2,818Professionalmedian $129 · 10th to 90th $81 to $204
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 $91.20 Median $128.82 Typical High $794.33 | Facility | None | $91.20 | $128.82 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $144.54 | Professional | None | $91.20 | $128.82 | $144.54 |
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 $79.43 Median $123.03 Typical High $204.17 | Professional | None | $79.43 | $123.03 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $141.25 Typical High $1,659.59 | Facility | None | $75.86 | $141.25 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $144.54 | Professional | None | $97.72 | $123.03 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $1,230.27 Typical High $1,348.96 | Facility | None | $158.49 | $1,230.27 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $954.99 | Professional | None | $91.20 | $144.54 | $954.99 |
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 $104.71 Median $151.36 Typical High $213.80 | Professional | None | $104.71 | $151.36 | $213.80 |
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 $45.71 Median $64.57 Typical High $91.20 | Facility | 52 · Reduced service | $45.71 | $64.57 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $25.70 Typical High $36.31 | Facility | 53 · Discontinued | $18.20 | $25.70 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $97.72 Typical High $134.90 | Facility | 54 · Surgery only | $69.18 | $97.72 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $19.50 Typical High $26.92 | Facility | 55 · Aftercare only | $13.80 | $19.50 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.88 Typical High $18.20 | Facility | 56 · Pre-op care only | $9.12 | $12.88 | $18.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $91.20 Typical High $125.89 | Facility | 78 · Unplanned return to OR | $64.57 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $45.71 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $18.20 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $95.50 Typical High $107.15 | Professional | 54 · Surgery only | $69.18 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.12 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $89.13 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $64.57 | $89.13 | $100.00 |
Where Kentucky sits
The same service costs 13.0 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 $4,547MT $350
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.