How much rates vary
Facilitymedian $1,660 · 10th to 90th $417 to $4,266Professionalmedian $380 · 10th to 90th $288 to $550
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 $316.23 Median $416.87 Typical High $851.14 | Facility | None | $316.23 | $416.87 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $537.03 | Professional | None | $316.23 | $416.87 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $4,265.80 | Facility | None | $831.76 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $478.63 | Professional | None | $288.40 | $371.54 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $4,897.79 | Facility | None | $295.12 | $478.63 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $478.63 | Professional | None | $269.15 | $371.54 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $3,630.78 | Facility | None | $524.81 | $1,659.59 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $2,290.87 | Professional | None | $302.00 | $407.38 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $151.36 | Professional | None | $33.11 | $33.11 | $151.36 |
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 $354.81 Median $457.09 Typical High $616.60 | Professional | None | $354.81 | $457.09 | $616.60 |
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 $158.49 Median $199.53 Typical High $269.15 | Facility | 52 · Reduced service | $158.49 | $199.53 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $79.43 Typical High $107.15 | Facility | 53 · Discontinued | $63.10 | $79.43 | $107.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $302.00 Typical High $398.11 | Facility | 54 · Surgery only | $234.42 | $302.00 | $398.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $79.43 | Facility | 55 · Aftercare only | $46.77 | $60.26 | $79.43 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $39.81 Typical High $53.70 | Facility | 56 · Pre-op care only | $31.62 | $39.81 | $53.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $281.84 Typical High $371.54 | Facility | 78 · Unplanned return to OR | $218.78 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $208.93 Typical High $269.15 | Professional | 52 · Reduced service | $158.49 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $63.10 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $316.23 Typical High $398.11 | Professional | 54 · Surgery only | $234.42 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $63.10 Typical High $79.43 | Professional | 55 · Aftercare only | $46.77 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $41.69 Typical High $53.70 | Professional | 56 · Pre-op care only | $31.62 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $295.12 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $218.78 | $295.12 | $371.54 |
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· 47th of 51
$380
AK $1,318NJ $331
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.