How much rates vary
Facilitymedian $575 · 10th to 90th $282 to $6,761Professionalmedian $295 · 10th to 90th $191 to $479
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 $245.47 Median $371.54 Typical High $549.54 | Facility | None | $245.47 | $371.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $549.54 | Professional | None | $288.40 | $416.87 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $354.81 | Professional | None | $190.55 | $257.04 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $575.44 | Facility | None | $275.42 | $446.68 | $575.44 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $457.09 | Professional | None | $245.47 | $346.74 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $467.74 Typical High $691.83 | Facility | None | $34.67 | $467.74 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $2,454.71 | Professional | None | $281.84 | $426.58 | $2,454.71 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $537.03 | Professional | None | $288.40 | $380.19 | $537.03 |
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 $123.03 Median $186.21 Typical High $275.42 | Facility | 52 · Reduced service | $123.03 | $186.21 | $275.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $74.13 Typical High $109.65 | Facility | 53 · Discontinued | $48.98 | $74.13 | $109.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $181.97 Median $275.42 Typical High $416.87 | Facility | 54 · Surgery only | $181.97 | $275.42 | $416.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $37.15 Median $54.95 Typical High $83.18 | Facility | 55 · Aftercare only | $37.15 | $54.95 | $83.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $24.55 Median $37.15 Typical High $54.95 | Facility | 56 · Pre-op care only | $24.55 | $37.15 | $54.95 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $257.04 Typical High $389.05 | Facility | 78 · Unplanned return to OR | $169.82 | $257.04 | $389.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $144.54 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $79.43 Typical High $109.65 | Professional | 53 · Discontinued | $58.88 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $295.12 Typical High $416.87 | Professional | 54 · Surgery only | $218.78 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $43.65 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $39.81 Typical High $54.95 | Professional | 56 · Pre-op care only | $28.84 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $275.42 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $204.17 | $275.42 | $389.05 |
Where Kentucky sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 51st of 51
$295
AK $1,259KY $295
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.