How much rates vary
Facilitymedian $282 · 10th to 90th $89 to $1,778Professionalmedian $251 · 10th to 90th $182 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 $416.87 | Professional | None | $223.87 | $269.15 | $416.87 |
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 $177.83 Median $218.78 Typical High $295.12 | Professional | None | $177.83 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $323.59 Typical High $446.68 | Professional | 50 · Both sides | $269.15 | $323.59 | $446.68 |
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 $223.87 Median $323.59 Typical High $389.05 | Professional | None | $223.87 | $323.59 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $467.74 | Facility | None | $34.67 | $154.88 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $1,584.89 | Professional | None | $251.19 | $295.12 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $104.71 | Professional | None | $33.11 | $33.11 | $104.71 |
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 $218.78 Median $275.42 Typical High $446.68 | Professional | None | $218.78 | $275.42 | $446.68 |
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 $141.25 Typical High $154.88 | Facility | 52 · Reduced service | $112.20 | $141.25 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $44.67 Median $56.23 Typical High $61.66 | Facility | 53 · Discontinued | $44.67 | $56.23 | $61.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $208.93 Typical High $234.42 | Facility | 54 · Surgery only | $169.82 | $208.93 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $41.69 Typical High $46.77 | Facility | 55 · Aftercare only | $33.88 | $41.69 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.39 Median $28.18 Typical High $30.90 | Facility | 56 · Pre-op care only | $22.39 | $28.18 | $30.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $194.98 Typical High $218.78 | Facility | 78 · Unplanned return to OR | $158.49 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $128.82 Typical High $154.88 | Professional | 52 · Reduced service | $112.20 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $51.29 Typical High $61.66 | Professional | 53 · Discontinued | $44.67 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $190.55 Typical High $234.42 | Professional | 54 · Surgery only | $169.82 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $33.88 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.70 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.39 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $158.49 | $177.83 | $218.78 |
Where Kentucky sits
The same service costs 5.4 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· 47th of 51
$251
AK $1,096TX $204
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.