How much rates vary
Facilitymedian $1,660 · 10th to 90th $288 to $4,169Professionalmedian $186 · 10th to 90th $151 to $339
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 $162.18 Median $239.88 Typical High $2,290.87 | Facility | None | $162.18 | $239.88 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $295.12 | Professional | None | $158.49 | $173.78 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $338.84 | Professional | None | $147.91 | $186.21 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $269.15 Typical High $2,818.38 | Facility | None | $141.25 | $269.15 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $275.42 | Professional | None | $169.82 | $234.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $1,659.59 Typical High $2,089.30 | Facility | None | $288.40 | $1,659.59 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $1,584.89 | Professional | None | $173.78 | $263.03 | $1,584.89 |
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 $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 $165.96 Median $257.04 Typical High $338.84 | Professional | None | $165.96 | $257.04 | $338.84 |
7 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 Professional Modifier 52 · Reduced service Typical Low $79.43 Median $87.10 Typical High $104.71 | Professional | 52 · Reduced service | $79.43 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $34.67 Typical High $42.66 | Professional | 53 · Discontinued | $31.62 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $131.83 Typical High $158.49 | Professional | 54 · Surgery only | $120.23 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $23.99 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.38 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.85 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $123.03 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $112.20 | $123.03 | $147.91 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | GC · Resident with teaching physician | $194.98 | $194.98 | $194.98 |
Where Kentucky sits
The same service costs 8.1 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 $4,634MT $570
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.