How much rates vary
Facilitymedian $1,660 · 10th to 90th $646 to $7,244Professionalmedian $813 · 10th to 90th $631 to $1,175
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 $645.65 Median $776.25 Typical High $1,380.38 | Facility | None | $645.65 | $776.25 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,348.96 | Professional | None | $645.65 | $794.33 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $630.96 Median $794.33 Typical High $1,174.90 | Professional | None | $630.96 | $794.33 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,659.59 | Facility | None | $691.83 | $1,122.02 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,148.15 | Professional | None | $691.83 | $977.24 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,862.09 | Facility | None | $1,148.15 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $5,011.87 | Professional | None | $707.95 | $870.96 | $5,011.87 |
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 $707.95 Median $891.25 Typical High $1,445.44 | Professional | None | $707.95 | $891.25 | $1,445.44 |
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 $323.59 Median $389.05 Typical High $478.63 | Facility | 52 · Reduced service | $323.59 | $389.05 | $478.63 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $190.55 | Facility | 53 · Discontinued | $128.82 | $154.88 | $190.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $724.44 | Facility | 54 · Surgery only | $478.63 | $575.44 | $724.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $144.54 | Facility | 55 · Aftercare only | $95.50 | $114.82 | $144.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $95.50 | Facility | 56 · Pre-op care only | $64.57 | $77.62 | $95.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $676.08 | Facility | 78 · Unplanned return to OR | $446.68 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $323.59 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $128.82 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $478.63 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $616.60 |
Where Kentucky sits
The same service costs 4.4 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· 48th of 51
$813
AK $3,090TX $708
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.