How much rates vary
Facilitymedian $1,259 · 10th to 90th $468 to $3,020Professionalmedian $537 · 10th to 90th $331 to $933
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 $398.11 Median $549.54 Typical High $851.14 | Facility | None | $398.11 | $549.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $741.31 | Professional | None | $398.11 | $616.60 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,905.46 Typical High $3,162.28 | Facility | None | $660.69 | $1,905.46 | $3,162.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $691.83 | Professional | None | $323.59 | $389.05 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $588.84 Typical High $1,047.13 | Professional | 50 · Both sides | $489.78 | $588.84 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $707.95 Typical High $1,548.82 | Facility | None | $416.87 | $707.95 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $741.31 | Professional | None | $407.38 | $602.56 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $1,318.26 | Facility | None | $512.86 | $1,071.52 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $4,168.69 | Professional | None | $457.09 | $707.95 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $338.84 | Professional | None | $33.11 | $33.11 | $338.84 |
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 $478.63 Median $691.83 Typical High $1,023.29 | Professional | None | $478.63 | $691.83 | $1,023.29 |
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 $199.53 Median $269.15 Typical High $354.81 | Facility | 52 · Reduced service | $199.53 | $269.15 | $354.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $109.65 Typical High $141.25 | Facility | 53 · Discontinued | $79.43 | $109.65 | $141.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $407.38 Typical High $537.03 | Facility | 54 · Surgery only | $302.00 | $407.38 | $537.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $81.28 Typical High $107.15 | Facility | 55 · Aftercare only | $60.26 | $81.28 | $107.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $54.95 Typical High $70.79 | Facility | 56 · Pre-op care only | $39.81 | $54.95 | $70.79 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $380.19 Typical High $501.19 | Facility | 78 · Unplanned return to OR | $281.84 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $269.15 Typical High $354.81 | Professional | 52 · Reduced service | $199.53 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $79.43 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $407.38 Typical High $537.03 | Professional | 54 · Surgery only | $302.00 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $81.28 Typical High $107.15 | Professional | 55 · Aftercare only | $60.26 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $39.81 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $380.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $281.84 | $380.19 | $501.19 |
Where Kentucky sits
The same service costs 3.0 times more in Colorado than in Maryland. 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 $5,106MD $1,697
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.