How much rates vary
Facilitymedian $1,259 · 10th to 90th $209 to $2,818Professionalmedian $200 · 10th to 90th $141 to $380
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 $165.96 Median $208.93 Typical High $851.14 | Facility | None | $165.96 | $208.93 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $316.23 | Professional | None | $165.96 | $208.93 | $316.23 |
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 $138.04 Median $173.78 Typical High $380.19 | Professional | None | $138.04 | $173.78 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $1,659.59 | Facility | None | $158.49 | $257.04 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $263.03 | Professional | None | $173.78 | $223.87 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $1,230.27 Typical High $1,348.96 | Facility | None | $263.03 | $1,230.27 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $1,778.28 | Professional | None | $162.18 | $251.19 | $1,778.28 |
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 $173.78 Median $251.19 Typical High $346.74 | Professional | None | $173.78 | $251.19 | $346.74 |
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 $83.18 Median $104.71 Typical High $165.96 | Facility | 52 · Reduced service | $83.18 | $104.71 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $41.69 Typical High $67.61 | Facility | 53 · Discontinued | $33.11 | $41.69 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $158.49 Typical High $251.19 | Facility | 54 · Surgery only | $125.89 | $158.49 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $31.62 Typical High $50.12 | Facility | 55 · Aftercare only | $25.12 | $31.62 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $33.88 | Facility | 56 · Pre-op care only | $16.60 | $20.89 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $147.91 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $117.49 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $83.18 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $33.11 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $125.89 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $31.62 Typical High $34.67 | Professional | 55 · Aftercare only | $25.12 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $147.91 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $117.49 | $147.91 | $162.18 |
Where Kentucky sits
The same service costs 4.6 times more in Alaska 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· 50th of 51
$209
AK $912UT $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.