How much rates vary
Facilitymedian $282 · 10th to 90th $110 to $1,778Professionalmedian $251 · 10th to 90th $191 to $398
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 $223.87 Median $281.84 Typical High $851.14 | Facility | None | $223.87 | $281.84 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $371.54 | Professional | None | $223.87 | $269.15 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $302.00 | Professional | None | $190.55 | $229.09 | $302.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $346.74 Typical High $457.09 | Professional | 50 · Both sides | $281.84 | $346.74 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $323.59 | Facility | None | $173.78 | $239.88 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $389.05 | Professional | None | $245.47 | $323.59 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $158.49 Typical High $457.09 | Facility | None | $34.67 | $158.49 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $1,819.70 | Professional | None | $251.19 | $302.00 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $120.23 | Professional | None | $33.11 | $33.11 | $120.23 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $457.09 | Professional | None | $223.87 | $281.84 | $457.09 |
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 $112.20 Median $138.04 Typical High $169.82 | Facility | 52 · Reduced service | $112.20 | $138.04 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $44.67 Median $56.23 Typical High $67.61 | Facility | 53 · Discontinued | $44.67 | $56.23 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $208.93 Typical High $257.04 | Facility | 54 · Surgery only | $169.82 | $208.93 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $41.69 Typical High $51.29 | Facility | 55 · Aftercare only | $33.88 | $41.69 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.39 Median $28.18 Typical High $33.88 | Facility | 56 · Pre-op care only | $22.39 | $28.18 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $194.98 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $158.49 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $128.82 Typical High $144.54 | Professional | 52 · Reduced service | $112.20 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $44.67 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $190.55 Typical High $218.78 | Professional | 54 · Surgery only | $169.82 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.90 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.70 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.39 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $177.83 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $158.49 | $177.83 | $204.17 |
Where Kentucky sits
The same service costs 5.9 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· 46th of 51
$251
AK $1,096TX $186
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.