How much rates vary
Facilitymedian $1,349 · 10th to 90th $380 to $3,890Professionalmedian $355 · 10th to 90th $224 to $603
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 $263.03 Median $467.74 Typical High $812.83 | Facility | None | $263.03 | $467.74 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $489.78 | Professional | None | $263.03 | $363.08 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $575.44 | Professional | None | $213.80 | $257.04 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $389.05 Typical High $851.14 | Professional | 50 · Both sides | $323.59 | $389.05 | $851.14 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $467.74 Typical High $1,202.26 | Facility | None | $288.40 | $467.74 | $1,202.26 |
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 $512.86 Median $851.14 Typical High $1,659.59 | Facility | None | $512.86 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $3,019.95 | Professional | None | $295.12 | $436.52 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $147.91 | Professional | None | $33.11 | $33.11 | $147.91 |
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 $331.13 Median $457.09 Typical High $676.08 | Professional | None | $331.13 | $457.09 | $676.08 |
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 $186.21 Typical High $281.84 | Facility | 52 · Reduced service | $131.83 | $186.21 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $75.86 Typical High $112.20 | Facility | 53 · Discontinued | $53.70 | $75.86 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $281.84 Typical High $426.58 | Facility | 54 · Surgery only | $199.53 | $281.84 | $426.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $56.23 Typical High $85.11 | Facility | 55 · Aftercare only | $39.81 | $56.23 | $85.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.02 Typical High $56.23 | Facility | 56 · Pre-op care only | $26.30 | $38.02 | $56.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $263.03 Typical High $398.11 | Facility | 78 · Unplanned return to OR | $186.21 | $263.03 | $398.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $186.21 Typical High $234.42 | Professional | 52 · Reduced service | $131.83 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $75.86 Typical High $93.33 | Professional | 53 · Discontinued | $53.70 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $199.53 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $39.81 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.02 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.30 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $263.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $186.21 | $263.03 | $323.59 |
Where Kentucky sits
The same service costs 4.9 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· 47th of 51
$372
AK $1,413UT $288
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.