How much rates vary
Facilitymedian $295 · 10th to 90th $89 to $1,862Professionalmedian $288 · 10th to 90th $229 to $427
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 $229.09 Median $295.12 Typical High $851.14 | Facility | None | $229.09 | $295.12 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $346.74 | Professional | None | $229.09 | $295.12 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $426.58 | Professional | None | $229.09 | $281.84 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $398.11 | Facility | None | $245.47 | $257.04 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $416.87 | Professional | None | $245.47 | $338.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $223.87 Typical High $398.11 | Facility | None | $34.67 | $223.87 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $1,778.28 | Professional | None | $251.19 | $331.13 | $1,778.28 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $549.54 | Professional | None | $245.47 | $316.23 | $549.54 |
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 $114.82 Median $147.91 Typical High $169.82 | Facility | 52 · Reduced service | $114.82 | $147.91 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $58.88 Typical High $69.18 | Facility | 53 · Discontinued | $45.71 | $58.88 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $173.78 Median $223.87 Typical High $257.04 | Facility | 54 · Surgery only | $173.78 | $223.87 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $51.29 | Facility | 55 · Aftercare only | $34.67 | $44.67 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $29.51 Typical High $34.67 | Facility | 56 · Pre-op care only | $22.91 | $29.51 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $208.93 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $162.18 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $147.91 Typical High $169.82 | Professional | 52 · Reduced service | $114.82 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $45.71 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $173.78 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $34.67 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.91 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $162.18 | $208.93 | $234.42 |
Where Kentucky sits
The same service costs 4.0 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
$288
AK $1,096TX $275
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.