How much rates vary
Facilitymedian $1,514 · 10th to 90th $389 to $4,169Professionalmedian $339 · 10th to 90th $282 to $603
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 $354.81 Median $389.05 Typical High $2,290.87 | Facility | None | $354.81 | $389.05 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $501.19 | Professional | None | $354.81 | $380.19 | $501.19 |
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 $257.04 Median $316.23 Typical High $398.11 | Professional | None | $257.04 | $316.23 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $524.81 Typical High $1,737.80 | Facility | None | $331.13 | $524.81 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $549.54 | Professional | None | $302.00 | $416.87 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,230.27 Typical High $1,862.09 | Facility | None | $489.78 | $1,230.27 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $1,862.09 | Professional | None | $323.59 | $467.74 | $1,862.09 |
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 $302.00 Median $354.81 Typical High $575.44 | Professional | None | $302.00 | $354.81 | $575.44 |
6 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 $181.97 Median $186.21 Typical High $194.98 | Professional | 52 · Reduced service | $181.97 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $75.86 Typical High $79.43 | Professional | 53 · Discontinued | $72.44 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $275.42 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $54.95 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $36.31 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $263.03 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $257.04 | $263.03 | $275.42 |
Where Kentucky sits
The same service costs 4.5 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 $4,914MT $1,099
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.