How much rates vary
Facilitymedian $1,995 · 10th to 90th $708 to $7,586Professionalmedian $692 · 10th to 90th $525 to $1,148
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 $588.84 Median $758.58 Typical High $1,000.00 | Facility | None | $588.84 | $758.58 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,000.00 | Professional | None | $588.84 | $776.25 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $8,511.38 | Facility | None | $1,000.00 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $891.25 | Professional | None | $501.19 | $645.65 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $4,897.79 | Facility | None | $549.54 | $912.01 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $933.25 | Professional | None | $562.34 | $794.33 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $3,630.78 | Facility | None | $954.99 | $1,862.09 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $4,073.80 | Professional | None | $630.96 | $870.96 | $4,073.80 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,445.44 | Professional | None | $724.44 | $933.25 | $1,445.44 |
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 $295.12 Median $380.19 Typical High $501.19 | Facility | 52 · Reduced service | $295.12 | $380.19 | $501.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $117.49 Median $151.36 Typical High $199.53 | Facility | 53 · Discontinued | $117.49 | $151.36 | $199.53 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $446.68 Median $562.34 Typical High $741.31 | Facility | 54 · Surgery only | $446.68 | $562.34 | $741.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $89.13 Median $112.20 Typical High $147.91 | Facility | 55 · Aftercare only | $89.13 | $112.20 | $147.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $58.88 Median $75.86 Typical High $100.00 | Facility | 56 · Pre-op care only | $58.88 | $75.86 | $100.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $524.81 Typical High $691.83 | Facility | 78 · Unplanned return to OR | $416.87 | $524.81 | $691.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $380.19 Typical High $501.19 | Professional | 52 · Reduced service | $295.12 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $151.36 Typical High $199.53 | Professional | 53 · Discontinued | $117.49 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $575.44 Typical High $741.31 | Professional | 54 · Surgery only | $446.68 | $575.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $114.82 Typical High $147.91 | Professional | 55 · Aftercare only | $89.13 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $75.86 Typical High $100.00 | Professional | 56 · Pre-op care only | $58.88 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $537.03 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $416.87 | $537.03 | $691.83 |
Where Kentucky sits
The same service costs 5.2 times more in Alaska 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· 49th of 51
$724
AK $3,548UT $676
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.