How much rates vary
Facilitymedian $1,660 · 10th to 90th $692 to $7,244Professionalmedian $871 · 10th to 90th $676 to $1,288
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 $691.83 Median $831.76 Typical High $1,479.11 | Facility | None | $691.83 | $831.76 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,445.44 | Professional | None | $691.83 | $851.14 | $1,445.44 |
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 $676.08 Median $831.76 Typical High $1,288.25 | Professional | None | $676.08 | $831.76 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,659.59 | Facility | None | $741.31 | $1,202.26 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,230.27 | Professional | None | $741.31 | $1,047.13 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,862.09 | Facility | None | $1,174.90 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $5,370.32 | Professional | None | $758.58 | $933.25 | $5,370.32 |
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 $741.31 Median $954.99 Typical High $1,548.82 | Professional | None | $741.31 | $954.99 | $1,548.82 |
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 $346.74 Median $416.87 Typical High $512.86 | Facility | 52 · Reduced service | $346.74 | $416.87 | $512.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $138.04 Median $165.96 Typical High $208.93 | Facility | 53 · Discontinued | $138.04 | $165.96 | $208.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $776.25 | Facility | 54 · Surgery only | $512.86 | $616.60 | $776.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $102.33 Median $125.89 Typical High $154.88 | Facility | 55 · Aftercare only | $102.33 | $125.89 | $154.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $69.18 Median $83.18 Typical High $102.33 | Facility | 56 · Pre-op care only | $69.18 | $83.18 | $102.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $575.44 Typical High $724.44 | Facility | 78 · Unplanned return to OR | $478.63 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $346.74 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $138.04 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $512.86 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $102.33 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $69.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $478.63 | $575.44 | $660.69 |
Where Kentucky sits
The same service costs 4.5 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· 44th of 51
$891
AK $3,311TX $741
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.