How much rates vary
Facilitymedian $1,259 · 10th to 90th $200 to $3,890Professionalmedian $224 · 10th to 90th $162 to $309
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 $154.88 Median $234.42 Typical High $851.14 | Facility | None | $154.88 | $234.42 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $269.15 | Professional | None | $154.88 | $229.09 | $269.15 |
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 $162.18 Median $223.87 Typical High $288.40 | Professional | None | $162.18 | $223.87 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $229.09 Typical High $295.12 | Facility | None | $169.82 | $229.09 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $288.40 | Professional | None | $154.88 | $245.47 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $213.80 Typical High $309.03 | Facility | None | $34.67 | $213.80 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $1,412.54 | Professional | None | $177.83 | $263.03 | $1,412.54 |
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 $173.78 Median $234.42 Typical High $398.11 | Professional | None | $173.78 | $234.42 | $398.11 |
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 $77.62 Median $117.49 Typical High $134.90 | Facility | 52 · Reduced service | $77.62 | $117.49 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $46.77 Typical High $53.70 | Facility | 53 · Discontinued | $30.90 | $46.77 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $173.78 Typical High $199.53 | Facility | 54 · Surgery only | $117.49 | $173.78 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $34.67 Typical High $40.74 | Facility | 55 · Aftercare only | $23.44 | $34.67 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.44 Typical High $26.92 | Facility | 56 · Pre-op care only | $15.49 | $23.44 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $109.65 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $77.62 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $30.90 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $117.49 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $23.44 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.49 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $158.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $109.65 | $158.49 | $186.21 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Texas. 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.
Kentucky· 50th of 51
$224
AK $759TX $214
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.