How much rates vary
Facilitymedian $2,291 · 10th to 90th $631 to $10,715Professionalmedian $692 · 10th to 90th $525 to $1,096
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 $537.03 Median $676.08 Typical High $1,230.27 | Facility | None | $537.03 | $676.08 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $831.76 | Professional | None | $537.03 | $660.69 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,584.89 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $870.96 | Professional | None | $524.81 | $630.96 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $851.14 Typical High $1,122.02 | Facility | None | $575.44 | $851.14 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $977.24 | Professional | None | $588.84 | $794.33 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,000.00 Typical High $3,090.30 | Facility | None | $724.44 | $1,000.00 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $4,365.16 | Professional | None | $602.56 | $776.25 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $354.81 | Professional | None | $33.11 | $33.11 | $354.81 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,230.27 | Professional | None | $630.96 | $812.83 | $1,230.27 |
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 $269.15 Median $338.84 Typical High $416.87 | Facility | 52 · Reduced service | $269.15 | $338.84 | $416.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $109.65 Median $134.90 Typical High $165.96 | Facility | 53 · Discontinued | $109.65 | $134.90 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $616.60 | Facility | 54 · Surgery only | $407.38 | $501.19 | $616.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $81.28 Median $100.00 Typical High $123.03 | Facility | 55 · Aftercare only | $81.28 | $100.00 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $53.70 Median $67.61 Typical High $83.18 | Facility | 56 · Pre-op care only | $53.70 | $67.61 | $83.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $467.74 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $380.19 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $331.13 Typical High $416.87 | Professional | 52 · Reduced service | $269.15 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $134.90 Typical High $165.96 | Professional | 53 · Discontinued | $109.65 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $616.60 | Professional | 54 · Surgery only | $407.38 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $100.00 Typical High $123.03 | Professional | 55 · Aftercare only | $81.28 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $66.07 Typical High $83.18 | Professional | 56 · Pre-op care only | $53.70 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $467.74 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $380.19 | $467.74 | $575.44 |
Where Kentucky sits
The same service costs 5.6 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· 44th of 51
$724
AK $2,630TX $468
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.