How much rates vary
Facilitymedian $1,318 · 10th to 90th $214 to $2,884Professionalmedian $200 · 10th to 90th $145 to $309
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 $213.80 Typical High $851.14 | Facility | None | $165.96 | $213.80 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $245.47 | Professional | None | $165.96 | $208.93 | $245.47 |
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 $144.54 Median $190.55 Typical High $309.03 | Professional | None | $144.54 | $190.55 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $2,818.38 | Facility | None | $165.96 | $275.42 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $281.84 | Professional | None | $186.21 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $1,318.26 Typical High $2,089.30 | Facility | None | $288.40 | $1,318.26 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $1,348.96 | Professional | None | $173.78 | $234.42 | $1,348.96 |
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 $169.82 Median $245.47 Typical High $371.54 | Professional | None | $169.82 | $245.47 | $371.54 |
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 $107.15 Typical High $128.82 | Facility | 52 · Reduced service | $83.18 | $107.15 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $42.66 Typical High $51.29 | Facility | 53 · Discontinued | $33.11 | $42.66 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $158.49 Typical High $190.55 | Facility | 54 · Surgery only | $123.03 | $158.49 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $32.36 Typical High $38.02 | Facility | 55 · Aftercare only | $24.55 | $32.36 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.38 Typical High $25.70 | Facility | 56 · Pre-op care only | $16.60 | $21.38 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $147.91 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $114.82 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $83.18 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $33.11 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $123.03 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $24.55 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $114.82 | $147.91 | $169.82 |
Where Kentucky sits
The same service costs 4.4 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
$204
AK $871UT $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.