How much rates vary
Facilitymedian $363 · 10th to 90th $105 to $3,548Professionalmedian $138 · 10th to 90th $91 to $186
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 $104.71 Median $134.90 Typical High $851.14 | Facility | None | $104.71 | $134.90 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $173.78 | Professional | None | $104.71 | $134.90 | $173.78 |
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 $91.20 Median $138.04 Typical High $181.97 | Professional | None | $91.20 | $138.04 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $123.03 Typical High $162.18 | Facility | None | $85.11 | $123.03 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $162.18 | Professional | None | $97.72 | $120.23 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $117.49 Typical High $398.11 | Facility | None | $34.67 | $117.49 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $870.96 | Professional | None | $102.33 | $134.90 | $870.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | None | $33.11 | $33.11 | $37.15 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $194.98 | Professional | None | $112.20 | $147.91 | $194.98 |
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 $52.48 Median $67.61 Typical High $87.10 | Facility | 52 · Reduced service | $52.48 | $67.61 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $26.92 Typical High $34.67 | Facility | 53 · Discontinued | $20.89 | $26.92 | $34.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $102.33 Typical High $128.82 | Facility | 54 · Surgery only | $79.43 | $102.33 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $25.70 | Facility | 55 · Aftercare only | $15.85 | $20.42 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $17.38 | Facility | 56 · Pre-op care only | $10.47 | $13.49 | $17.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $95.50 Typical High $120.23 | Facility | 78 · Unplanned return to OR | $74.13 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $67.61 Typical High $87.10 | Professional | 52 · Reduced service | $52.48 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.92 Typical High $34.67 | Professional | 53 · Discontinued | $20.89 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $102.33 Typical High $128.82 | Professional | 54 · Surgery only | $79.43 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.47 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $95.50 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $74.13 | $95.50 | $120.23 |
Where Kentucky sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 40th of 51
$138
AK $437NJ $110
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.