How much rates vary
Facilitymedian $562 · 10th to 90th $263 to $3,981Professionalmedian $339 · 10th to 90th $214 to $589
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 $371.54 Typical High $851.14 | Facility | None | $263.03 | $371.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $457.09 | Professional | None | $263.03 | $346.74 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $588.84 | Professional | None | $204.17 | $251.19 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $371.54 Typical High $870.96 | Professional | 50 · Both sides | $309.03 | $371.54 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $354.81 Typical High $457.09 | Facility | None | $239.88 | $354.81 | $457.09 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $467.74 | Professional | None | $257.04 | $380.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $331.13 Typical High $691.83 | Facility | None | $34.67 | $331.13 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $3,019.95 | Professional | None | $288.40 | $426.58 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $186.21 | Professional | None | $33.11 | $33.11 | $186.21 |
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 $316.23 Median $426.58 Typical High $630.96 | Professional | None | $316.23 | $426.58 | $630.96 |
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 $128.82 Median $181.97 Typical High $281.84 | Facility | 52 · Reduced service | $128.82 | $181.97 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $52.48 Median $74.13 Typical High $112.20 | Facility | 53 · Discontinued | $52.48 | $74.13 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $194.98 Median $275.42 Typical High $426.58 | Facility | 54 · Surgery only | $194.98 | $275.42 | $426.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $54.95 Typical High $85.11 | Facility | 55 · Aftercare only | $38.90 | $54.95 | $85.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.30 Median $36.31 Typical High $56.23 | Facility | 56 · Pre-op care only | $26.30 | $36.31 | $56.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $257.04 Typical High $398.11 | Facility | 78 · Unplanned return to OR | $181.97 | $257.04 | $398.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $181.97 Typical High $229.09 | Professional | 52 · Reduced service | $128.82 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $74.13 Typical High $91.20 | Professional | 53 · Discontinued | $52.48 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $275.42 Typical High $338.84 | Professional | 54 · Surgery only | $194.98 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $54.95 Typical High $67.61 | Professional | 55 · Aftercare only | $38.90 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $36.31 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.30 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $257.04 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $181.97 | $257.04 | $316.23 |
Where Kentucky sits
The same service costs 4.5 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
$347
AK $1,259TX $282
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.