How much rates vary
Facilitymedian $1,585 · 10th to 90th $269 to $8,511Professionalmedian $191 · 10th to 90th $107 to $1,862
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 $204.17 Median $416.87 Typical High $1,862.09 | Facility | None | $204.17 | $416.87 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $1,862.09 | Professional | None | $173.78 | $316.23 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $7,244.36 Typical High $11,220.18 | Facility | None | $1,584.89 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $213.80 | Professional | None | $104.71 | $125.89 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $9,772.37 | Facility | None | $295.12 | $478.63 | $9,772.37 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $478.63 | Professional | None | $302.00 | $398.11 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $524.81 Typical High $6,918.31 | Facility | None | $34.67 | $524.81 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $457.09 Typical High $10,715.19 | Professional | None | $213.80 | $457.09 | $10,715.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $72.44 | Professional | None | $33.11 | $33.11 | $72.44 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $8,511.38 | Facility | None | $977.24 | $1,862.09 | $8,511.38 |
United Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $2,089.30 | Professional | None | $162.18 | $257.04 | $2,089.30 |
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 $102.33 Median $158.49 Typical High $933.25 | Facility | 52 · Reduced service | $102.33 | $158.49 | $933.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $371.54 | Facility | 53 · Discontinued | $40.74 | $63.10 | $371.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $239.88 Typical High $1,380.38 | Facility | 54 · Surgery only | $154.88 | $239.88 | $1,380.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $275.42 | Facility | 55 · Aftercare only | $30.90 | $47.86 | $275.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $186.21 | Facility | 56 · Pre-op care only | $20.42 | $31.62 | $186.21 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $223.87 Typical High $1,288.25 | Facility | 78 · Unplanned return to OR | $144.54 | $223.87 | $1,288.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $162.18 Typical High $933.25 | Professional | 52 · Reduced service | $134.90 | $162.18 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $64.57 Typical High $371.54 | Professional | 53 · Discontinued | $54.95 | $64.57 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $1,380.38 | Professional | 54 · Surgery only | $204.17 | $245.47 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $275.42 | Professional | 55 · Aftercare only | $40.74 | $48.98 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $229.09 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $190.55 | $229.09 | $1,288.25 |
Where Kentucky sits
The same service costs 13.1 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 $15,603MT $1,192
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.