How much rates vary
Facilitymedian $1,622 · 10th to 90th $389 to $3,981Professionalmedian $331 · 10th to 90th $245 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 $316.23 Median $389.05 Typical High $851.14 | Facility | None | $316.23 | $389.05 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $467.74 | Professional | None | $323.59 | $389.05 | $467.74 |
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 $245.47 Median $288.40 Typical High $457.09 | Professional | None | $245.47 | $288.40 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $426.58 Typical High $660.69 | Professional | 50 · Both sides | $363.08 | $426.58 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $489.78 Typical High $2,344.23 | Facility | None | $309.03 | $489.78 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $501.19 | Professional | None | $338.84 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,659.59 Typical High $1,778.28 | Facility | None | $549.54 | $1,659.59 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $2,089.30 | Professional | None | $316.23 | $467.74 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $338.84 Median $467.74 Typical High $741.31 | Professional | None | $338.84 | $467.74 | $741.31 |
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 $158.49 Median $162.18 Typical High $199.53 | Facility | 52 · Reduced service | $158.49 | $162.18 | $199.53 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $79.43 | Facility | 53 · Discontinued | $63.10 | $64.57 | $79.43 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $295.12 | Facility | 54 · Surgery only | $234.42 | $245.47 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $58.88 | Facility | 55 · Aftercare only | $46.77 | $48.98 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $39.81 | Facility | 56 · Pre-op care only | $31.62 | $32.36 | $39.81 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $218.78 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $194.98 Typical High $234.42 | Professional | 52 · Reduced service | $162.18 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $77.62 Typical High $93.33 | Professional | 53 · Discontinued | $64.57 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $346.74 | Professional | 54 · Surgery only | $239.88 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.90 Typical High $46.77 | Professional | 56 · Pre-op care only | $32.36 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $275.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $223.87 | $275.42 | $323.59 |
Where Kentucky sits
The same service costs 4.9 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· 50th of 51
$372
AK $1,698UT $347
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.