How much rates vary
Facilitymedian $1,950 · 10th to 90th $372 to $8,128Professionalmedian $324 · 10th to 90th $224 to $550
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 $275.42 Median $371.54 Typical High $794.33 | Facility | None | $275.42 | $371.54 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $457.09 | Professional | None | $275.42 | $363.08 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $354.81 | Professional | None | $218.78 | $263.03 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $398.11 Typical High $524.81 | Professional | 50 · Both sides | $331.13 | $398.11 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $2,344.23 | Facility | None | $295.12 | $478.63 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $501.19 | Professional | None | $302.00 | $398.11 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $1,862.09 | Facility | None | $512.86 | $1,659.59 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $2,137.96 | Professional | None | $309.03 | $416.87 | $2,137.96 |
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 $302.00 Median $426.58 Typical High $630.96 | Professional | None | $302.00 | $426.58 | $630.96 |
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 $138.04 Median $173.78 Typical High $229.09 | Facility | 52 · Reduced service | $138.04 | $173.78 | $229.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $69.18 Typical High $91.20 | Facility | 53 · Discontinued | $54.95 | $69.18 | $91.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $346.74 | Facility | 54 · Surgery only | $208.93 | $257.04 | $346.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $51.29 Typical High $69.18 | Facility | 55 · Aftercare only | $41.69 | $51.29 | $69.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $27.54 Median $34.67 Typical High $45.71 | Facility | 56 · Pre-op care only | $27.54 | $34.67 | $45.71 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $239.88 Typical High $323.59 | Facility | 78 · Unplanned return to OR | $194.98 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $181.97 Typical High $229.09 | Professional | 52 · Reduced service | $138.04 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $91.20 | Professional | 53 · Discontinued | $54.95 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $269.15 Typical High $346.74 | Professional | 54 · Surgery only | $208.93 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $69.18 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $45.71 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $251.19 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $194.98 | $251.19 | $323.59 |
Where Kentucky sits
The same service costs 5.0 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· 49th of 51
$331
AK $1,622UT $324
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.