How much rates vary
Facilitymedian $1,660 · 10th to 90th $537 to $7,244Professionalmedian $550 · 10th to 90th $457 to $832
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 $478.63 Median $588.84 Typical High $812.83 | Facility | None | $478.63 | $588.84 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $851.14 | Professional | None | $478.63 | $588.84 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $758.58 | Professional | None | $436.52 | $537.03 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $1,659.59 | Facility | None | $512.86 | $831.76 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $851.14 | Professional | None | $512.86 | $724.44 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,862.09 | Facility | None | $870.96 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $3,467.37 | Professional | None | $524.81 | $645.65 | $3,467.37 |
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 $489.78 Median $630.96 Typical High $1,047.13 | Professional | None | $489.78 | $630.96 | $1,047.13 |
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 $239.88 Median $288.40 Typical High $331.13 | Facility | 52 · Reduced service | $239.88 | $288.40 | $331.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $95.50 Median $117.49 Typical High $131.83 | Facility | 53 · Discontinued | $95.50 | $117.49 | $131.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $354.81 Median $436.52 Typical High $489.78 | Facility | 54 · Surgery only | $354.81 | $436.52 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $70.79 Median $87.10 Typical High $100.00 | Facility | 55 · Aftercare only | $70.79 | $87.10 | $100.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $47.86 Median $58.88 Typical High $66.07 | Facility | 56 · Pre-op care only | $47.86 | $58.88 | $66.07 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $407.38 Typical High $457.09 | Facility | 78 · Unplanned return to OR | $331.13 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $239.88 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $95.50 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $354.81 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $70.79 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $47.86 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $331.13 | $407.38 | $457.09 |
Where Kentucky sits
The same service costs 4.3 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· 49th of 51
$562
AK $2,291TX $537
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.