How much rates vary
Facilitymedian $603 · 10th to 90th $263 to $3,981Professionalmedian $282 · 10th to 90th $178 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 $213.80 Median $309.03 Typical High $851.14 | Facility | None | $213.80 | $309.03 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $389.05 | Professional | None | $213.80 | $302.00 | $389.05 |
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 $173.78 Median $208.93 Typical High $426.58 | Professional | None | $173.78 | $208.93 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $316.23 Typical High $645.65 | Professional | 50 · Both sides | $257.04 | $316.23 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $309.03 Typical High $389.05 | Facility | None | $234.42 | $309.03 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $371.54 | Professional | None | $213.80 | $302.00 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $416.87 Typical High $1,862.09 | Facility | None | $263.03 | $416.87 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $2,691.53 | Professional | None | $239.88 | $354.81 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $138.04 | Professional | None | $33.11 | $33.11 | $138.04 |
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 $269.15 Median $371.54 Typical High $549.54 | Professional | None | $269.15 | $371.54 | $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 $107.15 Median $154.88 Typical High $257.04 | Facility | 52 · Reduced service | $107.15 | $154.88 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $63.10 Typical High $102.33 | Facility | 53 · Discontinued | $42.66 | $63.10 | $102.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $234.42 Typical High $380.19 | Facility | 54 · Surgery only | $162.18 | $234.42 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $46.77 Typical High $75.86 | Facility | 55 · Aftercare only | $32.36 | $46.77 | $75.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.90 Typical High $51.29 | Facility | 56 · Pre-op care only | $21.38 | $30.90 | $51.29 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $218.78 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $151.36 | $218.78 | $354.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $154.88 Typical High $194.98 | Professional | 52 · Reduced service | $107.15 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $63.10 Typical High $77.62 | Professional | 53 · Discontinued | $42.66 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $234.42 Typical High $288.40 | Professional | 54 · Surgery only | $162.18 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $32.36 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.38 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $218.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $151.36 | $218.78 | $269.15 |
Where Kentucky sits
The same service costs 4.3 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
$295
AK $1,023TX $240
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.