How much rates vary
Facilitymedian $1,698 · 10th to 90th $676 to $5,370Professionalmedian $759 · 10th to 90th $575 to $1,230
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 $562.34 Median $707.95 Typical High $851.14 | Facility | None | $562.34 | $707.95 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $912.01 | Professional | None | $562.34 | $707.95 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,370.32 | Facility | None | $724.44 | $1,995.26 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $977.24 | Professional | None | $575.44 | $691.83 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $4,897.79 | Facility | None | $602.56 | $977.24 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $977.24 | Professional | None | $602.56 | $812.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $3,630.78 | Facility | None | $1,071.52 | $1,659.59 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $4,168.69 | Professional | None | $616.60 | $891.25 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $213.80 | Professional | None | $33.11 | $33.11 | $213.80 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,412.54 | Professional | None | $741.31 | $933.25 | $1,412.54 |
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 $281.84 Median $354.81 Typical High $416.87 | Facility | 52 · Reduced service | $281.84 | $354.81 | $416.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $112.20 Median $141.25 Typical High $165.96 | Facility | 53 · Discontinued | $112.20 | $141.25 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $630.96 | Facility | 54 · Surgery only | $426.58 | $524.81 | $630.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $85.11 Median $104.71 Typical High $125.89 | Facility | 55 · Aftercare only | $85.11 | $104.71 | $125.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $56.23 Median $70.79 Typical High $83.18 | Facility | 56 · Pre-op care only | $56.23 | $70.79 | $83.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $489.78 Typical High $588.84 | Facility | 78 · Unplanned return to OR | $398.11 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $338.84 Typical High $416.87 | Professional | 52 · Reduced service | $281.84 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $165.96 | Professional | 53 · Discontinued | $112.20 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $630.96 | Professional | 54 · Surgery only | $426.58 | $501.19 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $100.00 Typical High $125.89 | Professional | 55 · Aftercare only | $85.11 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $83.18 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $467.74 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $398.11 | $467.74 | $588.84 |
Where Kentucky sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 40th of 51
$794
AK $3,236UT $562
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.