How much rates vary
Facilitymedian $1,230 · 10th to 90th $182 to $2,818Professionalmedian $182 · 10th to 90th $115 to $324
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 $181.97 Typical High $851.14 | Facility | None | $125.89 | $181.97 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $251.19 | Professional | None | $125.89 | $181.97 | $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 $109.65 Median $177.83 Typical High $316.23 | Professional | None | $109.65 | $177.83 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $1,659.59 | Facility | None | $120.23 | $194.98 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $199.53 | Professional | None | $134.90 | $169.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $1,230.27 Typical High $1,348.96 | Facility | None | $213.80 | $1,230.27 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $1,737.80 | Professional | None | $123.03 | $208.93 | $1,737.80 |
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 $147.91 Median $213.80 Typical High $295.12 | Professional | None | $147.91 | $213.80 | $295.12 |
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 $91.20 Typical High $162.18 | Facility | 52 · Reduced service | $63.10 | $91.20 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $36.31 Typical High $64.57 | Facility | 53 · Discontinued | $25.12 | $36.31 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $138.04 Typical High $239.88 | Facility | 54 · Surgery only | $95.50 | $138.04 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $27.54 Typical High $48.98 | Facility | 55 · Aftercare only | $19.05 | $27.54 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.20 Typical High $32.36 | Facility | 56 · Pre-op care only | $12.59 | $18.20 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $128.82 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $89.13 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $89.13 Typical High $100.00 | Professional | 52 · Reduced service | $63.10 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $35.48 Typical High $39.81 | Professional | 53 · Discontinued | $25.12 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $134.90 Typical High $151.36 | Professional | 54 · Surgery only | $95.50 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.92 Typical High $30.20 | Professional | 55 · Aftercare only | $19.05 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $17.78 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.59 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $125.89 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $89.13 | $125.89 | $141.25 |
Where Kentucky sits
The same service costs 9.9 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 $4,605MT $466
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.