How much rates vary
Facilitymedian $1,259 · 10th to 90th $437 to $2,884Professionalmedian $437 · 10th to 90th $302 to $617
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 $346.74 Median $512.86 Typical High $851.14 | Facility | None | $346.74 | $512.86 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $645.65 | Professional | None | $346.74 | $489.78 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $562.34 | Professional | None | $295.12 | $436.52 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $537.03 | Professional | None | $295.12 | $407.38 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $1,778.28 | Facility | None | $398.11 | $1,318.26 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $2,951.21 | Professional | None | $338.84 | $501.19 | $2,951.21 |
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 $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 $363.08 Median $489.78 Typical High $660.69 | Professional | None | $363.08 | $489.78 | $660.69 |
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 $173.78 Median $251.19 Typical High $323.59 | Facility | 52 · Reduced service | $173.78 | $251.19 | $323.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $102.33 Typical High $128.82 | Facility | 53 · Discontinued | $69.18 | $102.33 | $128.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $380.19 Typical High $478.63 | Facility | 54 · Surgery only | $257.04 | $380.19 | $478.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $75.86 Typical High $95.50 | Facility | 55 · Aftercare only | $51.29 | $75.86 | $95.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $51.29 Typical High $64.57 | Facility | 56 · Pre-op care only | $34.67 | $51.29 | $64.57 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $354.81 Typical High $446.68 | Facility | 78 · Unplanned return to OR | $239.88 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $245.47 Typical High $323.59 | Professional | 52 · Reduced service | $173.78 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $97.72 Typical High $128.82 | Professional | 53 · Discontinued | $69.18 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $371.54 Typical High $478.63 | Professional | 54 · Surgery only | $257.04 | $371.54 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $74.13 Typical High $95.50 | Professional | 55 · Aftercare only | $51.29 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $48.98 Typical High $64.57 | Professional | 56 · Pre-op care only | $34.67 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $346.74 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $239.88 | $346.74 | $446.68 |
Where Kentucky sits
The same service costs 3.7 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· 45th of 51
$437
AK $1,445NJ $389
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.