How much rates vary
Facilitymedian $1,820 · 10th to 90th $295 to $7,244Professionalmedian $288 · 10th to 90th $204 to $501
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 $239.88 Median $295.12 Typical High $794.33 | Facility | None | $239.88 | $295.12 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $363.08 | Professional | None | $239.88 | $269.15 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $501.19 | Professional | None | $199.53 | $234.42 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $1,412.54 | Facility | None | $257.04 | $416.87 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $426.58 | Professional | None | $263.03 | $354.81 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $977.24 Typical High $1,862.09 | Facility | None | $457.09 | $977.24 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $3,162.28 | Professional | None | $263.03 | $363.08 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $144.54 | Professional | None | $33.11 | $33.11 | $144.54 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $524.81 | Professional | None | $288.40 | $354.81 | $524.81 |
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 $120.23 Median $147.91 Typical High $295.12 | Facility | 52 · Reduced service | $120.23 | $147.91 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $120.23 | Facility | 53 · Discontinued | $47.86 | $58.88 | $120.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $181.97 Median $223.87 Typical High $446.68 | Facility | 54 · Surgery only | $181.97 | $223.87 | $446.68 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $36.31 Median $44.67 Typical High $89.13 | Facility | 55 · Aftercare only | $36.31 | $44.67 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $58.88 | Facility | 56 · Pre-op care only | $23.99 | $29.51 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $208.93 Typical High $416.87 | Facility | 78 · Unplanned return to OR | $169.82 | $208.93 | $416.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $134.90 Typical High $165.96 | Professional | 52 · Reduced service | $120.23 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $53.70 Typical High $66.07 | Professional | 53 · Discontinued | $47.86 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $251.19 | Professional | 54 · Surgery only | $181.97 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.92 Typical High $33.11 | Professional | 56 · Pre-op care only | $23.99 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $190.55 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $169.82 | $190.55 | $234.42 |
Where Kentucky sits
The same service costs 6.8 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
$295
AK $1,288UT $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.