How much rates vary
Facilitymedian $427 · 10th to 90th $155 to $3,548Professionalmedian $219 · 10th to 90th $151 to $309
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 $154.88 Median $234.42 Typical High $851.14 | Facility | None | $154.88 | $234.42 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $295.12 | Professional | None | $154.88 | $234.42 | $295.12 |
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 $147.91 Median $213.80 Typical High $257.04 | Professional | None | $147.91 | $213.80 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $223.87 Typical High $281.84 | Facility | None | $147.91 | $223.87 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $234.42 | Professional | None | $131.83 | $186.21 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $213.80 Typical High $524.81 | Facility | None | $34.67 | $213.80 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $1,258.93 | Professional | None | $151.36 | $229.09 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $87.10 | Professional | None | $33.11 | $33.11 | $87.10 |
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 $181.97 Median $251.19 Typical High $338.84 | Professional | None | $181.97 | $251.19 | $338.84 |
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 $77.62 Median $104.71 Typical High $147.91 | Facility | 52 · Reduced service | $77.62 | $104.71 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $42.66 Typical High $58.88 | Facility | 53 · Discontinued | $30.90 | $42.66 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $158.49 Typical High $223.87 | Facility | 54 · Surgery only | $117.49 | $158.49 | $223.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $31.62 Typical High $44.67 | Facility | 55 · Aftercare only | $23.44 | $31.62 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.89 Typical High $29.51 | Facility | 56 · Pre-op care only | $15.49 | $20.89 | $29.51 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $147.91 Typical High $208.93 | Facility | 78 · Unplanned return to OR | $109.65 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $112.20 Typical High $147.91 | Professional | 52 · Reduced service | $77.62 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $30.90 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $223.87 | Professional | 54 · Surgery only | $117.49 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.88 Typical High $44.67 | Professional | 55 · Aftercare only | $23.44 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.39 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.49 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $158.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $109.65 | $158.49 | $208.93 |
Where Kentucky sits
The same service costs 3.6 times more in Alaska 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· 43rd of 51
$219
AK $646TX $178
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.