How much rates vary
Facilitymedian $1,122 · 10th to 90th $174 to $3,890Professionalmedian $182 · 10th to 90th $123 to $324
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 $125.89 Median $177.83 Typical High $851.14 | Facility | None | $125.89 | $177.83 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $229.09 | Professional | None | $125.89 | $154.88 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $323.59 | Professional | None | $120.23 | $181.97 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $239.88 | Facility | None | $134.90 | $186.21 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $223.87 | Professional | None | $123.03 | $181.97 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $186.21 Typical High $398.11 | Facility | None | $34.67 | $186.21 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $1,698.24 | Professional | None | $138.04 | $199.53 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $67.61 | Professional | None | $33.11 | $33.11 | $67.61 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $295.12 | Professional | None | $141.25 | $199.53 | $295.12 |
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 $63.10 Median $89.13 Typical High $158.49 | Facility | 52 · Reduced service | $63.10 | $89.13 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $35.48 Typical High $64.57 | Facility | 53 · Discontinued | $25.12 | $35.48 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $134.90 Typical High $239.88 | Facility | 54 · Surgery only | $93.33 | $134.90 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $26.92 Typical High $47.86 | Facility | 55 · Aftercare only | $18.62 | $26.92 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $17.78 Typical High $32.36 | Facility | 56 · Pre-op care only | $12.59 | $17.78 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $125.89 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $87.10 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $63.10 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $35.48 Typical High $44.67 | Professional | 53 · Discontinued | $25.12 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $93.33 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $18.62 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $17.78 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.59 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $87.10 | $125.89 | $154.88 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 47th of 51
$182
AK $603FL $174
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.