How much rates vary
Facilitymedian $339 · 10th to 90th $89 to $1,778Professionalmedian $309 · 10th to 90th $257 to $525
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 $331.13 Median $346.74 Typical High $851.14 | Facility | None | $331.13 | $346.74 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $416.87 | Professional | None | $316.23 | $338.84 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $446.68 | Professional | None | $234.42 | $281.84 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $426.58 Typical High $676.08 | Professional | 50 · Both sides | $354.81 | $426.58 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $288.40 Typical High $398.11 | Facility | None | $218.78 | $288.40 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $478.63 | Professional | None | $316.23 | $407.38 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $199.53 Typical High $501.19 | Facility | None | $34.67 | $199.53 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $2,570.40 | Professional | None | $275.42 | $323.59 | $2,570.40 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $501.19 | Professional | None | $263.03 | $302.00 | $501.19 |
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 $165.96 Median $173.78 Typical High $239.88 | Facility | 52 · Reduced service | $165.96 | $173.78 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $95.50 | Facility | 53 · Discontinued | $66.07 | $69.18 | $95.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $363.08 | Facility | 54 · Surgery only | $245.47 | $257.04 | $363.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $72.44 | Facility | 55 · Aftercare only | $48.98 | $51.29 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $34.67 Typical High $47.86 | Facility | 56 · Pre-op care only | $33.11 | $34.67 | $47.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $338.84 | Facility | 78 · Unplanned return to OR | $229.09 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $169.82 Typical High $190.55 | Professional | 52 · Reduced service | $158.49 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $77.62 | Professional | 53 · Discontinued | $64.57 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $288.40 | Professional | 54 · Surgery only | $239.88 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $38.02 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $234.42 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $223.87 | $234.42 | $269.15 |
Where Kentucky sits
The same service costs 7.4 times more in Hawaii than in Florida. 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
HI $3,255FL $440
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.