How much rates vary
Facilitymedian $263 · 10th to 90th $110 to $1,905Professionalmedian $275 · 10th to 90th $191 to $417
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 $269.15 Typical High $851.14 | Facility | None | $194.98 | $269.15 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $338.84 | Professional | None | $194.98 | $263.03 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $338.84 | Professional | None | $190.55 | $269.15 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $239.88 Typical High $302.00 | Facility | None | $181.97 | $239.88 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $302.00 | Professional | None | $177.83 | $257.04 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $229.09 Typical High $524.81 | Facility | None | $34.67 | $229.09 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $1,412.54 | Professional | None | $186.21 | $316.23 | $1,412.54 |
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 $245.47 Median $338.84 Typical High $478.63 | Professional | None | $245.47 | $338.84 | $478.63 |
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 $95.50 Median $131.83 Typical High $169.82 | Facility | 52 · Reduced service | $95.50 | $131.83 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $52.48 Typical High $67.61 | Facility | 53 · Discontinued | $38.90 | $52.48 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $257.04 | Facility | 54 · Surgery only | $144.54 | $199.53 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $39.81 Typical High $51.29 | Facility | 55 · Aftercare only | $28.84 | $39.81 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.30 Typical High $33.88 | Facility | 56 · Pre-op care only | $19.50 | $26.30 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $186.21 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $134.90 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $131.83 Typical High $169.82 | Professional | 52 · Reduced service | $95.50 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $53.70 Typical High $67.61 | Professional | 53 · Discontinued | $38.90 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $257.04 | Professional | 54 · Surgery only | $144.54 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $39.81 Typical High $51.29 | Professional | 55 · Aftercare only | $28.84 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.30 Typical High $33.88 | Professional | 56 · Pre-op care only | $19.50 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $186.21 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $134.90 | $186.21 | $239.88 |
Where Kentucky sits
The same service costs 3.7 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· 46th of 51
$275
WI $891TX $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.