How much rates vary
Facilitymedian $851 · 10th to 90th $158 to $2,818Professionalmedian $302 · 10th to 90th $229 to $479
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 $269.15 Median $331.13 Typical High $851.14 | Facility | None | $269.15 | $331.13 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $416.87 | Professional | None | $251.19 | $302.00 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $363.08 | Professional | None | $229.09 | $275.42 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $416.87 Typical High $537.03 | Professional | 50 · Both sides | $346.74 | $416.87 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $331.13 | Facility | None | $173.78 | $288.40 | $331.13 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $467.74 | Professional | None | $288.40 | $380.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $398.11 Typical High $1,318.26 | Facility | None | $147.91 | $398.11 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $1,995.26 | Professional | None | $295.12 | $363.08 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $125.89 | Professional | None | $33.11 | $33.11 | $125.89 |
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 $269.15 Median $338.84 Typical High $549.54 | Professional | None | $269.15 | $338.84 | $549.54 |
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 $131.83 Median $165.96 Typical High $186.21 | Facility | 52 · Reduced service | $131.83 | $165.96 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $66.07 Typical High $74.13 | Facility | 53 · Discontinued | $53.70 | $66.07 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $245.47 Typical High $281.84 | Facility | 54 · Surgery only | $199.53 | $245.47 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $50.12 Typical High $56.23 | Facility | 55 · Aftercare only | $39.81 | $50.12 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.11 Typical High $37.15 | Facility | 56 · Pre-op care only | $26.92 | $33.11 | $37.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $229.09 Typical High $263.03 | Facility | 78 · Unplanned return to OR | $186.21 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $151.36 Typical High $177.83 | Professional | 52 · Reduced service | $131.83 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $53.70 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $229.09 Typical High $269.15 | Professional | 54 · Surgery only | $199.53 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $45.71 Typical High $53.70 | Professional | 55 · Aftercare only | $39.81 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $213.80 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $186.21 | $213.80 | $251.19 |
Where Kentucky sits
The same service costs 5.9 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· 46th of 51
$309
AK $1,288UT $219
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.