How much rates vary
Facilitymedian $1,995 · 10th to 90th $269 to $8,128Professionalmedian $204 · 10th to 90th $129 to $617
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 $154.88 Median $269.15 Typical High $794.33 | Facility | None | $154.88 | $269.15 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $331.13 | Professional | None | $154.88 | $269.15 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $616.60 | Professional | None | $128.82 | $154.88 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $229.09 Typical High $912.01 | Professional | 50 · Both sides | $194.98 | $229.09 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $81.28 Median $97.72 Typical High $389.05 | Professional | 62 · Two surgeons | $81.28 | $97.72 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $269.15 Typical High $5,888.44 | Facility | None | $169.82 | $269.15 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $275.42 | Professional | None | $154.88 | $229.09 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $1,862.09 Typical High $5,495.41 | Facility | None | $302.00 | $1,862.09 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $3,235.94 | Professional | None | $173.78 | $302.00 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $91.20 | Professional | None | $33.11 | $33.11 | $91.20 |
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 $190.55 Median $323.59 Typical High $537.03 | Professional | None | $190.55 | $323.59 | $537.03 |
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 $77.62 Median $134.90 Typical High $302.00 | Facility | 52 · Reduced service | $77.62 | $134.90 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $53.70 Typical High $120.23 | Facility | 53 · Discontinued | $30.90 | $53.70 | $120.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $199.53 Typical High $457.09 | Facility | 54 · Surgery only | $117.49 | $199.53 | $457.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $39.81 Typical High $91.20 | Facility | 55 · Aftercare only | $23.44 | $39.81 | $91.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $26.92 Typical High $60.26 | Facility | 56 · Pre-op care only | $15.49 | $26.92 | $60.26 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $186.21 Typical High $426.58 | Facility | 78 · Unplanned return to OR | $109.65 | $186.21 | $426.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $77.62 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $52.48 Typical High $66.07 | Professional | 53 · Discontinued | $30.90 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $194.98 Typical High $251.19 | Professional | 54 · Surgery only | $117.49 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.90 Typical High $50.12 | Professional | 55 · Aftercare only | $23.44 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $26.30 Typical High $33.11 | Professional | 56 · Pre-op care only | $15.49 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $181.97 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $109.65 | $181.97 | $234.42 |
Where Kentucky sits
The same service costs 5.1 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· 48th of 51
$224
AK $977TX $191
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.