How much rates vary
Facilitymedian $2,188 · 10th to 90th $331 to $9,772Professionalmedian $603 · 10th to 90th $389 to $1,047
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 $331.13 Median $524.81 Typical High $851.14 | Facility | None | $331.13 | $524.81 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $1,000.00 | Professional | None | $331.13 | $537.03 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,584.89 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $794.33 | Professional | None | $398.11 | $575.44 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $870.96 Typical High $1,202.26 | Professional | 50 · Both sides | $588.84 | $870.96 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $363.08 Typical High $501.19 | Professional | 62 · Two surgeons | $251.19 | $363.08 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $316.23 Typical High $489.78 | Facility | None | $257.04 | $316.23 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $501.19 | Professional | None | $295.12 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $302.00 Typical High $1,071.52 | Facility | None | $34.67 | $302.00 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $933.25 Typical High $3,388.44 | Professional | None | $338.84 | $933.25 | $3,388.44 |
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 $489.78 Median $758.58 Typical High $1,348.96 | Professional | None | $489.78 | $758.58 | $1,348.96 |
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 $165.96 Median $239.88 Typical High $346.74 | Facility | 52 · Reduced service | $165.96 | $239.88 | $346.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $67.61 Median $95.50 Typical High $138.04 | Facility | 53 · Discontinued | $67.61 | $95.50 | $138.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $251.19 Median $363.08 Typical High $524.81 | Facility | 54 · Surgery only | $251.19 | $363.08 | $524.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $50.12 Median $72.44 Typical High $104.71 | Facility | 55 · Aftercare only | $50.12 | $72.44 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $47.86 Typical High $69.18 | Facility | 56 · Pre-op care only | $33.11 | $47.86 | $69.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $338.84 Typical High $489.78 | Facility | 78 · Unplanned return to OR | $234.42 | $338.84 | $489.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $239.88 Typical High $346.74 | Professional | 52 · Reduced service | $165.96 | $239.88 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $95.50 Typical High $141.25 | Professional | 53 · Discontinued | $67.61 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $363.08 Typical High $524.81 | Professional | 54 · Surgery only | $251.19 | $363.08 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $72.44 Typical High $104.71 | Professional | 55 · Aftercare only | $50.12 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $47.86 Typical High $70.79 | Professional | 56 · Pre-op care only | $33.11 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $338.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $234.42 | $338.84 | $489.78 |
Where Kentucky sits
The same service costs 4.3 times more in Wisconsin 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· 36th of 51
$631
WI $1,862TX $437
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.