How much rates vary
Facilitymedian $2,089 · 10th to 90th $692 to $8,128Professionalmedian $776 · 10th to 90th $562 to $1,175
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 $575.44 Median $691.83 Typical High $1,047.13 | Facility | None | $575.44 | $691.83 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $851.14 | Professional | None | $575.44 | $691.83 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,174.90 | Professional | None | $549.54 | $758.58 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,122.02 Typical High $1,778.28 | Professional | 50 · Both sides | $831.76 | $1,122.02 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $2,570.40 | Facility | None | $602.56 | $1,000.00 | $2,570.40 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,023.29 | Professional | None | $616.60 | $870.96 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $2,290.87 | Facility | None | $1,071.52 | $1,862.09 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $5,495.41 | Professional | None | $630.96 | $933.25 | $5,495.41 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,380.38 | Professional | None | $575.44 | $776.25 | $1,380.38 |
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 $281.84 Median $346.74 Typical High $524.81 | Facility | 52 · Reduced service | $281.84 | $346.74 | $524.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $114.82 Median $138.04 Typical High $208.93 | Facility | 53 · Discontinued | $114.82 | $138.04 | $208.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $776.25 | Facility | 54 · Surgery only | $426.58 | $524.81 | $776.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $85.11 Median $104.71 Typical High $154.88 | Facility | 55 · Aftercare only | $85.11 | $104.71 | $154.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $57.54 Median $69.18 Typical High $104.71 | Facility | 56 · Pre-op care only | $57.54 | $69.18 | $104.71 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $489.78 Typical High $724.44 | Facility | 78 · Unplanned return to OR | $398.11 | $489.78 | $724.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $281.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $114.82 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $426.58 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $57.54 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $549.54 |
Where Kentucky sits
The same service costs 3.7 times more in Connecticut than in Arkansas. 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.
Physician feeFacility fee
CT $7,673AR $2,094
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.