How much rates vary
Facilitymedian $1,259 · 10th to 90th $363 to $2,884Professionalmedian $324 · 10th to 90th $234 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 $281.84 Median $389.05 Typical High $794.33 | Facility | None | $281.84 | $389.05 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $616.60 | Professional | None | $281.84 | $389.05 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $446.68 | Professional | None | $223.87 | $275.42 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $407.38 Typical High $660.69 | Professional | 50 · Both sides | $338.84 | $407.38 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $2,041.74 | Facility | None | $295.12 | $467.74 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $489.78 | Professional | None | $288.40 | $416.87 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,348.96 Typical High $1,659.59 | Facility | None | $512.86 | $1,348.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $2,238.72 | Professional | None | $302.00 | $457.09 | $2,238.72 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $660.69 | Professional | None | $295.12 | $416.87 | $660.69 |
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 $141.25 Median $154.88 Typical High $213.80 | Facility | 52 · Reduced service | $141.25 | $154.88 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $85.11 | Facility | 53 · Discontinued | $56.23 | $61.66 | $85.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $316.23 | Facility | 54 · Surgery only | $208.93 | $229.09 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $63.10 | Facility | 55 · Aftercare only | $41.69 | $46.77 | $63.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $42.66 | Facility | 56 · Pre-op care only | $28.18 | $30.90 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $194.98 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $141.25 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $75.86 Typical High $85.11 | Professional | 53 · Discontinued | $56.23 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $288.40 Typical High $316.23 | Professional | 54 · Surgery only | $208.93 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $57.54 Typical High $63.10 | Professional | 55 · Aftercare only | $41.69 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $28.18 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $269.15 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $194.98 | $269.15 | $295.12 |
Where Kentucky sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.