How much rates vary
Facilitymedian $1,950 · 10th to 90th $537 to $7,762Professionalmedian $813 · 10th to 90th $288 to $2,455
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 $338.84 Median $851.14 Typical High $1,995.26 | Facility | None | $338.84 | $851.14 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $1,318.26 Typical High $2,089.30 | Professional | None | $338.84 | $1,318.26 | $2,089.30 |
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 $275.42 Median $812.83 Typical High $2,187.76 | Professional | None | $275.42 | $812.83 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $1,230.27 Typical High $3,235.94 | Professional | 50 · Both sides | $416.87 | $1,230.27 | $3,235.94 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $2,691.53 | Facility | None | $295.12 | $489.78 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $501.19 | Professional | None | $275.42 | $426.58 | $501.19 |
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 $363.08 Median $1,412.54 Typical High $10,232.93 | Professional | None | $363.08 | $1,412.54 | $10,232.93 |
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 $380.19 Median $1,000.00 Typical High $2,344.23 | Professional | None | $380.19 | $1,000.00 | $2,344.23 |
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 $169.82 Median $223.87 Typical High $977.24 | Facility | 52 · Reduced service | $169.82 | $223.87 | $977.24 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $67.61 Median $89.13 Typical High $398.11 | Facility | 53 · Discontinued | $67.61 | $89.13 | $398.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $251.19 Median $338.84 Typical High $1,479.11 | Facility | 54 · Surgery only | $251.19 | $338.84 | $1,479.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $50.12 Median $67.61 Typical High $295.12 | Facility | 55 · Aftercare only | $50.12 | $67.61 | $295.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.88 Median $44.67 Typical High $199.53 | Facility | 56 · Pre-op care only | $33.88 | $44.67 | $199.53 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $316.23 Typical High $1,380.38 | Facility | 78 · Unplanned return to OR | $234.42 | $316.23 | $1,380.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $467.74 Typical High $977.24 | Professional | 52 · Reduced service | $169.82 | $467.74 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $190.55 Typical High $398.11 | Professional | 53 · Discontinued | $67.61 | $190.55 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $707.95 Typical High $1,479.11 | Professional | 54 · Surgery only | $251.19 | $707.95 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $141.25 Typical High $295.12 | Professional | 55 · Aftercare only | $50.12 | $141.25 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $93.33 Typical High $199.53 | Professional | 56 · Pre-op care only | $33.88 | $93.33 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $660.69 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $234.42 | $660.69 | $1,380.38 |
Where Kentucky sits
The same service costs 5.8 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
$955
AK $3,548NE $617
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.