How much rates vary
Facilitymedian $1,660 · 10th to 90th $355 to $4,074Professionalmedian $363 · 10th to 90th $219 to $631
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 $269.15 Median $354.81 Typical High $851.14 | Facility | None | $269.15 | $354.81 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $389.05 | Professional | None | $269.15 | $346.74 | $389.05 |
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 $218.78 Median $363.08 Typical High $512.86 | Professional | None | $218.78 | $363.08 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $2,818.38 | Facility | None | $251.19 | $416.87 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $426.58 | Professional | None | $257.04 | $363.08 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,659.59 Typical High $2,041.74 | Facility | None | $457.09 | $1,659.59 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $1,905.46 | Professional | None | $263.03 | $457.09 | $1,905.46 |
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 $323.59 Median $478.63 Typical High $776.25 | Professional | None | $323.59 | $478.63 | $776.25 |
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 $134.90 Median $165.96 Typical High $177.83 | Facility | 52 · Reduced service | $134.90 | $165.96 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $66.07 Typical High $70.79 | Facility | 53 · Discontinued | $53.70 | $66.07 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $245.47 Typical High $269.15 | Facility | 54 · Surgery only | $199.53 | $245.47 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $48.98 Typical High $53.70 | Facility | 55 · Aftercare only | $39.81 | $48.98 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.11 Typical High $35.48 | Facility | 56 · Pre-op care only | $26.92 | $33.11 | $35.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | 78 · Unplanned return to OR | $186.21 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $134.90 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $53.70 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $199.53 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $186.21 | $245.47 | $269.15 |
Where Kentucky sits
The same service costs 4.8 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· 48th of 51
$380
AK $1,549UT $324
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.