How much rates vary
Facilitymedian $1,445 · 10th to 90th $479 to $3,981Professionalmedian $347 · 10th to 90th $224 to $631
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 $302.00 Median $478.63 Typical High $851.14 | Facility | None | $302.00 | $478.63 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $588.84 | Professional | None | $302.00 | $371.54 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $436.52 | Professional | None | $223.87 | $263.03 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $398.11 Typical High $660.69 | Professional | 50 · Both sides | $338.84 | $398.11 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $524.81 Typical High $1,905.46 | Facility | None | $275.42 | $524.81 | $1,905.46 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $537.03 | Professional | None | $363.08 | $436.52 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,348.96 Typical High $1,659.59 | Facility | None | $602.56 | $1,348.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $3,630.78 | Professional | None | $331.13 | $537.03 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $131.83 | Professional | None | $33.11 | $33.11 | $131.83 |
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 $295.12 Median $436.52 Typical High $724.44 | Professional | None | $295.12 | $436.52 | $724.44 |
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 $151.36 Median $239.88 Typical High $338.84 | Facility | 52 · Reduced service | $151.36 | $239.88 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $95.50 Typical High $134.90 | Facility | 53 · Discontinued | $60.26 | $95.50 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $354.81 Typical High $512.86 | Facility | 54 · Surgery only | $223.87 | $354.81 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $70.79 Typical High $102.33 | Facility | 55 · Aftercare only | $44.67 | $70.79 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.20 Median $47.86 Typical High $67.61 | Facility | 56 · Pre-op care only | $30.20 | $47.86 | $67.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $331.13 Typical High $478.63 | Facility | 78 · Unplanned return to OR | $208.93 | $331.13 | $478.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $234.42 Typical High $295.12 | Professional | 52 · Reduced service | $151.36 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $93.33 Typical High $117.49 | Professional | 53 · Discontinued | $60.26 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $346.74 Typical High $446.68 | Professional | 54 · Surgery only | $223.87 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $69.18 Typical High $89.13 | Professional | 55 · Aftercare only | $44.67 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $46.77 Typical High $58.88 | Professional | 56 · Pre-op care only | $30.20 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $323.59 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $208.93 | $323.59 | $416.87 |
Where Kentucky sits
The same service costs 4.7 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· 50th of 51
$372
AK $1,660TX $355
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.