How much rates vary
Facilitymedian $1,413 · 10th to 90th $525 to $3,890Professionalmedian $501 · 10th to 90th $398 to $891
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 $380.19 Median $575.44 Typical High $851.14 | Facility | None | $380.19 | $575.44 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $707.95 | Professional | None | $478.63 | $575.44 | $707.95 |
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 $380.19 Median $426.58 Typical High $562.34 | Professional | None | $380.19 | $426.58 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $831.76 Typical High $1,122.02 | Facility | None | $524.81 | $831.76 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $851.14 | Professional | None | $575.44 | $707.95 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $1,659.59 | Facility | None | $602.56 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $3,467.37 | Professional | None | $537.03 | $676.08 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $173.78 | Professional | None | $33.11 | $33.11 | $173.78 |
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 $512.86 Median $676.08 Typical High $1,071.52 | Professional | None | $512.86 | $676.08 | $1,071.52 |
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 $190.55 Median $288.40 Typical High $354.81 | Facility | 52 · Reduced service | $190.55 | $288.40 | $354.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $75.86 Median $114.82 Typical High $141.25 | Facility | 53 · Discontinued | $75.86 | $114.82 | $141.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $281.84 Median $426.58 Typical High $537.03 | Facility | 54 · Surgery only | $281.84 | $426.58 | $537.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $57.54 Median $85.11 Typical High $107.15 | Facility | 55 · Aftercare only | $57.54 | $85.11 | $107.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.02 Median $57.54 Typical High $70.79 | Facility | 56 · Pre-op care only | $38.02 | $57.54 | $70.79 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $398.11 Typical High $501.19 | Facility | 78 · Unplanned return to OR | $263.03 | $398.11 | $501.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $288.40 Typical High $354.81 | Professional | 52 · Reduced service | $239.88 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $537.03 | Professional | 54 · Surgery only | $363.08 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $398.11 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $398.11 | $501.19 |
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· 49th of 51
$513
AK $2,399TX $427
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.