How much rates vary
Facilitymedian $1,122 · 10th to 90th $257 to $2,818Professionalmedian $229 · 10th to 90th $158 to $339
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 $208.93 Median $257.04 Typical High $851.14 | Facility | None | $208.93 | $257.04 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $257.04 | Professional | None | $208.93 | $234.42 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $263.03 | Professional | None | $158.49 | $194.98 | $263.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $288.40 Typical High $398.11 | Professional | 50 · Both sides | $239.88 | $288.40 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $1,412.54 | Facility | None | $223.87 | $363.08 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $371.54 | Professional | None | $251.19 | $302.00 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $977.24 Typical High $1,318.26 | Facility | None | $363.08 | $977.24 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $1,412.54 | Professional | None | $213.80 | $269.15 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $79.43 | Professional | None | $33.11 | $33.11 | $79.43 |
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 $190.55 Median $251.19 Typical High $398.11 | Professional | None | $190.55 | $251.19 | $398.11 |
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 $104.71 Median $128.82 Typical High $134.90 | Facility | 52 · Reduced service | $104.71 | $128.82 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $51.29 Typical High $53.70 | Facility | 53 · Discontinued | $41.69 | $51.29 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $194.98 Typical High $199.53 | Facility | 54 · Surgery only | $154.88 | $194.98 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $38.90 Typical High $40.74 | Facility | 55 · Aftercare only | $30.90 | $38.90 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $25.70 Typical High $26.92 | Facility | 56 · Pre-op care only | $20.89 | $25.70 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $181.97 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $144.54 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $104.71 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $41.69 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $154.88 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.89 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $165.96 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $144.54 | $165.96 | $181.97 |
Where Kentucky sits
The same service costs 5.4 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· 48th of 51
$229
AK $1,023UT $191
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.