How much rates vary
Facilitymedian $1,698 · 10th to 90th $447 to $4,365Professionalmedian $398 · 10th to 90th $275 to $813
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 $302.00 Median $501.19 Typical High $851.14 | Facility | None | $302.00 | $501.19 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $630.96 | Professional | None | $302.00 | $489.78 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $4,265.80 | Facility | None | $831.76 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $436.52 | Professional | None | $269.15 | $323.59 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $524.81 Typical High $4,897.79 | Facility | None | $331.13 | $524.81 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $549.54 | Professional | None | $331.13 | $446.68 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,659.59 Typical High $3,630.78 | Facility | None | $489.78 | $1,659.59 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $3,019.95 | Professional | None | $331.13 | $562.34 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $117.49 | Professional | None | $33.11 | $33.11 | $117.49 |
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 $380.19 Median $616.60 Typical High $1,000.00 | Professional | None | $380.19 | $616.60 | $1,000.00 |
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 $151.36 Median $213.80 Typical High $316.23 | Facility | 52 · Reduced service | $151.36 | $213.80 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $87.10 Typical High $125.89 | Facility | 53 · Discontinued | $60.26 | $87.10 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $229.09 Median $323.59 Typical High $467.74 | Facility | 54 · Surgery only | $229.09 | $323.59 | $467.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $45.71 Median $64.57 Typical High $93.33 | Facility | 55 · Aftercare only | $45.71 | $64.57 | $93.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.20 Median $42.66 Typical High $63.10 | Facility | 56 · Pre-op care only | $30.20 | $42.66 | $63.10 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $302.00 Typical High $436.52 | Facility | 78 · Unplanned return to OR | $213.80 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $245.47 Typical High $316.23 | Professional | 52 · Reduced service | $151.36 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $100.00 Typical High $125.89 | Professional | 53 · Discontinued | $60.26 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $371.54 Typical High $467.74 | Professional | 54 · Surgery only | $229.09 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $74.13 Typical High $93.33 | Professional | 55 · Aftercare only | $45.71 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $48.98 Typical High $63.10 | Professional | 56 · Pre-op care only | $30.20 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $346.74 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $213.80 | $346.74 | $436.52 |
Where Kentucky sits
The same service costs 4.9 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· 49th of 51
$407
AK $1,862TX $380
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.