How much rates vary
Facilitymedian $1,660 · 10th to 90th $617 to $7,244Professionalmedian $646 · 10th to 90th $525 to $955
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 $549.54 Median $645.65 Typical High $1,047.13 | Facility | None | $549.54 | $645.65 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $912.01 | Professional | None | $549.54 | $645.65 | $912.01 |
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 $501.19 Median $616.60 Typical High $891.25 | Professional | None | $501.19 | $616.60 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $954.99 Typical High $1,659.59 | Facility | None | $588.84 | $954.99 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $977.24 | Professional | None | $575.44 | $812.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,288.25 Typical High $1,862.09 | Facility | None | $724.44 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $4,168.69 | Professional | None | $602.56 | $724.44 | $4,168.69 |
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 $575.44 Median $724.44 Typical High $1,202.26 | Professional | None | $575.44 | $724.44 | $1,202.26 |
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 $275.42 Median $323.59 Typical High $398.11 | Facility | 52 · Reduced service | $275.42 | $323.59 | $398.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $158.49 | Facility | 53 · Discontinued | $109.65 | $131.83 | $158.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $588.84 | Facility | 54 · Surgery only | $407.38 | $489.78 | $588.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $117.49 | Facility | 55 · Aftercare only | $81.28 | $97.72 | $117.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $54.95 Median $64.57 Typical High $79.43 | Facility | 56 · Pre-op care only | $54.95 | $64.57 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $549.54 | Facility | 78 · Unplanned return to OR | $380.19 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $323.59 Typical High $371.54 | Professional | 52 · Reduced service | $275.42 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $109.65 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $549.54 | Professional | 54 · Surgery only | $407.38 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $109.65 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $64.57 Typical High $74.13 | Professional | 56 · Pre-op care only | $54.95 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $512.86 |
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· 49th of 51
$661
AK $2,630TX $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.