How much rates vary
Facilitymedian $2,089 · 10th to 90th $550 to $8,128Professionalmedian $575 · 10th to 90th $347 to $933
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 $416.87 Median $549.54 Typical High $851.14 | Facility | None | $416.87 | $549.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $676.08 | Professional | None | $416.87 | $549.54 | $676.08 |
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 $346.74 Median $416.87 Typical High $870.96 | Professional | None | $346.74 | $416.87 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $724.44 Typical High $2,691.53 | Facility | None | $446.68 | $724.44 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $741.31 | Professional | None | $457.09 | $616.60 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,862.09 Typical High $2,290.87 | Facility | None | $691.83 | $1,862.09 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $4,365.16 | Professional | None | $467.74 | $676.08 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $354.81 | Professional | None | $33.11 | $33.11 | $354.81 |
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 $537.03 Median $691.83 Typical High $1,023.29 | Professional | None | $537.03 | $691.83 | $1,023.29 |
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 $208.93 Median $275.42 Typical High $407.38 | Facility | 52 · Reduced service | $208.93 | $275.42 | $407.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $83.18 Median $109.65 Typical High $165.96 | Facility | 53 · Discontinued | $83.18 | $109.65 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $316.23 Median $407.38 Typical High $616.60 | Facility | 54 · Surgery only | $316.23 | $407.38 | $616.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $123.03 | Facility | 55 · Aftercare only | $63.10 | $81.28 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $41.69 Median $54.95 Typical High $81.28 | Facility | 56 · Pre-op care only | $41.69 | $54.95 | $81.28 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $380.19 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $295.12 | $380.19 | $575.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $275.42 Typical High $338.84 | Professional | 52 · Reduced service | $208.93 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $109.65 Typical High $134.90 | Professional | 53 · Discontinued | $83.18 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $316.23 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $54.95 Typical High $67.61 | Professional | 56 · Pre-op care only | $41.69 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $380.19 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $295.12 | $380.19 | $478.63 |
Where Kentucky sits
The same service costs 5.8 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· 44th of 51
$603
AK $2,455TX $427
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.