How much rates vary
Facilitymedian $1,622 · 10th to 90th $389 to $8,128Professionalmedian $407 · 10th to 90th $263 to $676
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 $309.03 Median $426.58 Typical High $851.14 | Facility | None | $309.03 | $426.58 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $524.81 | Professional | None | $309.03 | $416.87 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $660.69 | Professional | None | $251.19 | $302.00 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $457.09 Typical High $977.24 | Professional | 50 · Both sides | $380.19 | $457.09 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $537.03 Typical High $1,202.26 | Facility | None | $288.40 | $537.03 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $537.03 | Professional | None | $309.03 | $446.68 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $851.14 Typical High $2,290.87 | Facility | None | $602.56 | $851.14 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $3,467.37 | Professional | None | $346.74 | $512.86 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $181.97 | Professional | None | $33.11 | $33.11 | $181.97 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $776.25 | Professional | None | $389.05 | $524.81 | $776.25 |
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 $154.88 Median $213.80 Typical High $323.59 | Facility | 52 · Reduced service | $154.88 | $213.80 | $323.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $85.11 Typical High $131.83 | Facility | 53 · Discontinued | $61.66 | $85.11 | $131.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $323.59 Typical High $489.78 | Facility | 54 · Surgery only | $234.42 | $323.59 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $64.57 Typical High $97.72 | Facility | 55 · Aftercare only | $46.77 | $64.57 | $97.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $42.66 Typical High $64.57 | Facility | 56 · Pre-op care only | $30.90 | $42.66 | $64.57 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $302.00 Typical High $457.09 | Facility | 78 · Unplanned return to OR | $218.78 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $154.88 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $61.66 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $234.42 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $46.77 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $30.90 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $218.78 | $302.00 | $371.54 |
Where Kentucky sits
The same service costs 4.8 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· 47th of 51
$427
AK $1,549UT $324
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.