How much rates vary
Facilitymedian $794 · 10th to 90th $525 to $3,548Professionalmedian $692 · 10th to 90th $550 to $1,000
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 $602.56 Median $707.95 Typical High $851.14 | Facility | None | $602.56 | $707.95 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $870.96 | Professional | None | $602.56 | $724.44 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $891.25 | Professional | None | $537.03 | $645.65 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $2,041.74 | Facility | None | $645.65 | $1,047.13 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,096.48 | Professional | None | $660.69 | $912.01 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,148.15 Typical High $1,479.11 | Facility | None | $34.67 | $1,148.15 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $4,466.84 | Professional | None | $645.65 | $812.83 | $4,466.84 |
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 $741.31 Typical High $1,258.93 | Professional | None | $588.84 | $741.31 | $1,258.93 |
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 $302.00 Median $354.81 Typical High $407.38 | Facility | 52 · Reduced service | $302.00 | $354.81 | $407.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $162.18 | Facility | 53 · Discontinued | $120.23 | $144.54 | $162.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $616.60 | Facility | 54 · Surgery only | $457.09 | $537.03 | $616.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $123.03 | Facility | 55 · Aftercare only | $91.20 | $107.15 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $60.26 Median $70.79 Typical High $81.28 | Facility | 56 · Pre-op care only | $60.26 | $70.79 | $81.28 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $426.58 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $302.00 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $120.23 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $457.09 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $575.44 |
Where Kentucky sits
The same service costs 4.9 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· 50th of 51
$708
AK $2,884TX $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.