How much rates vary
Facilitymedian $1,660 · 10th to 90th $234 to $4,074Professionalmedian $219 · 10th to 90th $166 to $398
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 $190.55 Median $234.42 Typical High $851.14 | Facility | None | $190.55 | $234.42 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $281.84 | Professional | None | $186.21 | $218.78 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $398.11 | Professional | None | $165.96 | $218.78 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $275.42 Typical High $2,818.38 | Facility | None | $169.82 | $275.42 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $281.84 | Professional | None | $154.88 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $1,659.59 Typical High $2,041.74 | Facility | None | $295.12 | $1,659.59 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $2,344.23 | Professional | None | $173.78 | $263.03 | $2,344.23 |
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 $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 $177.83 Median $269.15 Typical High $363.08 | Professional | None | $177.83 | $269.15 | $363.08 |
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 $95.50 Median $117.49 Typical High $218.78 | Facility | 52 · Reduced service | $95.50 | $117.49 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $87.10 | Facility | 53 · Discontinued | $38.02 | $46.77 | $87.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $173.78 Typical High $323.59 | Facility | 54 · Surgery only | $144.54 | $173.78 | $323.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $66.07 | Facility | 55 · Aftercare only | $28.84 | $35.48 | $66.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $43.65 | Facility | 56 · Pre-op care only | $19.05 | $23.44 | $43.65 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $162.18 Typical High $302.00 | Facility | 78 · Unplanned return to OR | $134.90 | $162.18 | $302.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $109.65 Typical High $131.83 | Professional | 52 · Reduced service | $93.33 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $37.15 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $138.04 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $151.36 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $128.82 | $151.36 | $186.21 |
Where Kentucky sits
The same service costs 5.9 times more in Oklahoma than in Utah. 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· 48th of 51
$224
OK $1,175UT $200
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.