How much rates vary
Facilitymedian $355 · 10th to 90th $158 to $3,548Professionalmedian $191 · 10th to 90th $135 to $275
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 $158.49 Median $218.78 Typical High $851.14 | Facility | None | $158.49 | $218.78 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $275.42 | Professional | None | $158.49 | $218.78 | $275.42 |
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 $128.82 Median $181.97 Typical High $245.47 | Professional | None | $128.82 | $181.97 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $190.55 Typical High $245.47 | Facility | None | $128.82 | $190.55 | $245.47 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $245.47 | Professional | None | $134.90 | $190.55 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $181.97 Typical High $691.83 | Facility | None | $34.67 | $181.97 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $1,174.90 | Professional | None | $154.88 | $218.78 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $63.10 | Professional | None | $33.11 | $33.11 | $63.10 |
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 $169.82 Median $223.87 Typical High $309.03 | Professional | None | $169.82 | $223.87 | $309.03 |
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 $79.43 Median $109.65 Typical High $138.04 | Facility | 52 · Reduced service | $79.43 | $109.65 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $43.65 Typical High $54.95 | Facility | 53 · Discontinued | $31.62 | $43.65 | $54.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $208.93 | Facility | 54 · Surgery only | $120.23 | $165.96 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $41.69 | Facility | 55 · Aftercare only | $23.99 | $33.11 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $27.54 | Facility | 56 · Pre-op care only | $15.85 | $21.88 | $27.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $154.88 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $112.20 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $107.15 Typical High $138.04 | Professional | 52 · Reduced service | $79.43 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $42.66 Typical High $54.95 | Professional | 53 · Discontinued | $31.62 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $120.23 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $23.99 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.85 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $151.36 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $112.20 | $151.36 | $194.98 |
Where Kentucky sits
The same service costs 3.8 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· 49th of 51
$191
AK $646NJ $170
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.