How much rates vary
Facilitymedian $891 · 10th to 90th $186 to $3,802Professionalmedian $282 · 10th to 90th $182 to $398
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 $186.21 Median $309.03 Typical High $794.33 | Facility | None | $186.21 | $309.03 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $467.74 | Professional | None | $186.21 | $309.03 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $371.54 | Professional | None | $173.78 | $257.04 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $363.08 | Facility | None | $199.53 | $275.42 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $331.13 | Professional | None | $204.17 | $281.84 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $346.74 Typical High $1,659.59 | Facility | None | $245.47 | $346.74 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $354.81 Typical High $1,905.46 | Professional | None | $208.93 | $354.81 | $1,905.46 |
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 $194.98 Median $302.00 Typical High $512.86 | Professional | None | $194.98 | $302.00 | $512.86 |
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 $93.33 Median $154.88 Typical High $173.78 | Facility | 52 · Reduced service | $93.33 | $154.88 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $61.66 Typical High $70.79 | Facility | 53 · Discontinued | $37.15 | $61.66 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $234.42 Typical High $263.03 | Facility | 54 · Surgery only | $141.25 | $234.42 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $46.77 Typical High $52.48 | Facility | 55 · Aftercare only | $28.18 | $46.77 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.90 Typical High $35.48 | Facility | 56 · Pre-op care only | $18.62 | $30.90 | $35.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $218.78 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $131.83 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $37.15 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $141.25 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $28.18 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.62 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $131.83 | $208.93 | $245.47 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska 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.
Kentucky· 48th of 51
$288
AK $891MD $257
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.