How much rates vary
Facilitymedian $1,000 · 10th to 90th $186 to $3,802Professionalmedian $251 · 10th to 90th $162 to $398
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 $194.98 Median $275.42 Typical High $851.14 | Facility | None | $194.98 | $275.42 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $346.74 | Professional | None | $194.98 | $275.42 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $316.23 | Professional | None | $162.18 | $223.87 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $457.09 | Facility | None | $181.97 | $295.12 | $457.09 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $302.00 | Professional | None | $204.17 | $257.04 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $346.74 Typical High $1,659.59 | Facility | None | $323.59 | $346.74 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $1,479.11 | Professional | None | $186.21 | $309.03 | $1,479.11 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $467.74 | Professional | None | $239.88 | $331.13 | $467.74 |
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 $97.72 Median $123.03 Typical High $173.78 | Facility | 52 · Reduced service | $97.72 | $123.03 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $48.98 Typical High $69.18 | Facility | 53 · Discontinued | $38.90 | $48.98 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $181.97 Typical High $263.03 | Facility | 54 · Surgery only | $144.54 | $181.97 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $52.48 | Facility | 55 · Aftercare only | $28.84 | $37.15 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $34.67 | Facility | 56 · Pre-op care only | $19.50 | $24.55 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $169.82 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $134.90 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $97.72 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $54.95 Typical High $69.18 | Professional | 53 · Discontinued | $38.90 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $144.54 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $28.84 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $27.54 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.50 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $134.90 | $190.55 | $245.47 |
Where Kentucky sits
The same service costs 3.7 times more in Wisconsin 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
$251
WI $891UT $240
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.