How much rates vary
Facilitymedian $1,862 · 10th to 90th $537 to $7,762Professionalmedian $776 · 10th to 90th $331 to $1,905
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 $389.05 Median $851.14 Typical High $1,548.82 | Facility | None | $389.05 | $851.14 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $1,122.02 Typical High $1,819.70 | Professional | None | $389.05 | $1,122.02 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $660.69 Typical High $1,905.46 | Professional | None | $323.59 | $660.69 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $1,000.00 Typical High $2,884.03 | Professional | 50 · Both sides | $478.63 | $1,000.00 | $2,884.03 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $562.34 Typical High $2,691.53 | Facility | None | $302.00 | $562.34 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $588.84 | Professional | None | $389.05 | $489.78 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,819.70 Typical High $1,949.84 | Facility | None | $562.34 | $1,819.70 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,380.38 Typical High $7,943.28 | Professional | None | $407.38 | $1,380.38 | $7,943.28 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,000.00 Typical High $2,238.72 | Professional | None | $446.68 | $1,000.00 | $2,238.72 |
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 $194.98 Median $257.04 Typical High $776.25 | Facility | 52 · Reduced service | $194.98 | $257.04 | $776.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $77.62 Median $104.71 Typical High $309.03 | Facility | 53 · Discontinued | $77.62 | $104.71 | $309.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $288.40 Median $389.05 Typical High $1,174.90 | Facility | 54 · Surgery only | $288.40 | $389.05 | $1,174.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $58.88 Median $77.62 Typical High $234.42 | Facility | 55 · Aftercare only | $58.88 | $77.62 | $234.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.90 Median $52.48 Typical High $154.88 | Facility | 56 · Pre-op care only | $38.90 | $52.48 | $154.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $363.08 Typical High $1,096.48 | Facility | 78 · Unplanned return to OR | $269.15 | $363.08 | $1,096.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $524.81 Typical High $776.25 | Professional | 52 · Reduced service | $194.98 | $524.81 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $208.93 Typical High $309.03 | Professional | 53 · Discontinued | $77.62 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $794.33 Typical High $1,174.90 | Professional | 54 · Surgery only | $288.40 | $794.33 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $158.49 Typical High $234.42 | Professional | 55 · Aftercare only | $58.88 | $158.49 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $104.71 Typical High $154.88 | Professional | 56 · Pre-op care only | $38.90 | $104.71 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $741.31 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $269.15 | $741.31 | $1,096.48 |
Where Kentucky sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 49th of 51
$933
AK $3,020NE $692
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.