How much rates vary
Facilitymedian $110 · 10th to 90th $42 to $1,479Professionalmedian $45 · 10th to 90th $35 to $91
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 $41.69 Median $46.77 Typical High $52.48 | Facility | None | $41.69 | $46.77 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $54.95 | Professional | None | $41.69 | $46.77 | $54.95 |
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 $34.67 Median $42.66 Typical High $85.11 | Professional | None | $34.67 | $42.66 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $562.34 Typical High $933.25 | Facility | None | $44.67 | $562.34 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $74.13 | Professional | None | $44.67 | $63.10 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $75.86 | Facility | None | $34.67 | $74.13 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $275.42 | Professional | None | $42.66 | $48.98 | $275.42 |
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 $40.74 Median $47.86 Typical High $85.11 | Professional | None | $40.74 | $47.86 | $85.11 |
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 $20.89 Median $23.44 Typical High $26.30 | Facility | 52 · Reduced service | $20.89 | $23.44 | $26.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.32 Median $9.33 Typical High $10.47 | Facility | 53 · Discontinued | $8.32 | $9.33 | $10.47 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.90 Median $35.48 Typical High $38.90 | Facility | 54 · Surgery only | $30.90 | $35.48 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.17 Median $7.08 Typical High $7.76 | Facility | 55 · Aftercare only | $6.17 | $7.08 | $7.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.68 Typical High $5.25 | Facility | 56 · Pre-op care only | $4.17 | $4.68 | $5.25 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $33.11 Typical High $36.31 | Facility | 78 · Unplanned return to OR | $28.84 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $23.44 Typical High $25.70 | Professional | 52 · Reduced service | $20.89 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.33 Typical High $10.23 | Professional | 53 · Discontinued | $8.32 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $35.48 Typical High $38.90 | Professional | 54 · Surgery only | $30.90 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.08 Typical High $7.76 | Professional | 55 · Aftercare only | $6.17 | $7.08 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.68 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.17 | $4.68 | $5.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $33.11 Typical High $36.31 | Professional | 78 · Unplanned return to OR | $28.84 | $33.11 | $36.31 |
Where Kentucky sits
The same service costs 4.6 times more in Alaska than in New York. 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
$45.71
AK $200NY $43.65
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.