How much rates vary
Facilitymedian $1,413 · 10th to 90th $617 to $6,918Professionalmedian $661 · 10th to 90th $537 to $977
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 $562.34 Median $724.44 Typical High $1,230.27 | Facility | None | $562.34 | $724.44 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,174.90 | Professional | None | $562.34 | $691.83 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | None | $549.54 | $724.44 | $724.44 |
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 $524.81 Median $645.65 Typical High $933.25 | Professional | None | $524.81 | $645.65 | $933.25 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $851.14 Typical High $1,659.59 | Facility | None | $602.56 | $851.14 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,000.00 | Professional | None | $691.83 | $758.58 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $3,981.07 | Professional | None | $616.60 | $707.95 | $3,981.07 |
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 $588.84 Median $724.44 Typical High $1,174.90 | Professional | None | $588.84 | $724.44 | $1,174.90 |
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 $281.84 Median $323.59 Typical High $380.19 | Facility | 52 · Reduced service | $281.84 | $323.59 | $380.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $151.36 | Facility | 53 · Discontinued | $112.20 | $128.82 | $151.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $575.44 | Facility | 54 · Surgery only | $416.87 | $478.63 | $575.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $83.18 Median $95.50 Typical High $114.82 | Facility | 55 · Aftercare only | $83.18 | $95.50 | $114.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $56.23 Median $64.57 Typical High $75.86 | Facility | 56 · Pre-op care only | $56.23 | $64.57 | $75.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $537.03 | Facility | 78 · Unplanned return to OR | $389.05 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $323.59 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $562.34 | Professional | 54 · Surgery only | $416.87 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $95.50 Typical High $112.20 | Professional | 55 · Aftercare only | $83.18 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $64.57 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $389.05 | $446.68 | $524.81 |
Where Kentucky sits
The same service costs 4.6 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· 45th of 51
$692
AK $2,692TX $589
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.