How much rates vary
Facilitymedian $245 · 10th to 90th $89 to $1,778Professionalmedian $245 · 10th to 90th $162 to $380
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 $199.53 Median $275.42 Typical High $851.14 | Facility | None | $199.53 | $275.42 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $275.42 | Professional | None | $199.53 | $223.87 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $363.08 | Professional | None | $158.49 | $190.55 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $218.78 Typical High $323.59 | Facility | None | $165.96 | $218.78 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $346.74 | Professional | None | $213.80 | $281.84 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $389.05 | Facility | None | $34.67 | $154.88 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $1,949.84 | Professional | None | $218.78 | $288.40 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $120.23 | Professional | None | $33.11 | $33.11 | $120.23 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $416.87 | Professional | None | $223.87 | $269.15 | $416.87 |
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 $100.00 Median $123.03 Typical High $181.97 | Facility | 52 · Reduced service | $100.00 | $123.03 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $48.98 Typical High $72.44 | Facility | 53 · Discontinued | $39.81 | $48.98 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $147.91 Median $181.97 Typical High $275.42 | Facility | 54 · Surgery only | $147.91 | $181.97 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $29.51 Median $37.15 Typical High $54.95 | Facility | 55 · Aftercare only | $29.51 | $37.15 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $24.55 Typical High $36.31 | Facility | 56 · Pre-op care only | $19.95 | $24.55 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $169.82 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $138.04 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $112.20 Typical High $138.04 | Professional | 52 · Reduced service | $100.00 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $44.67 Typical High $54.95 | Professional | 53 · Discontinued | $39.81 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $169.82 Typical High $208.93 | Professional | 54 · Surgery only | $147.91 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.88 Typical High $41.69 | Professional | 55 · Aftercare only | $29.51 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.39 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.95 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $158.49 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $138.04 | $158.49 | $194.98 |
Where Kentucky sits
The same service costs 5.1 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· 43rd of 51
$245
AK $955UT $186
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.