How much rates vary
Facilitymedian $501 · 10th to 90th $102 to $3,981Professionalmedian $138 · 10th to 90th $102 to $240
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 $102.33 Median $144.54 Typical High $851.14 | Facility | None | $102.33 | $144.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $204.17 | Professional | None | $102.33 | $144.54 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $239.88 | Professional | None | $97.72 | $131.83 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $120.23 Typical High $165.96 | Facility | None | $102.33 | $120.23 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $173.78 | Professional | None | $104.71 | $144.54 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $107.15 Typical High $691.83 | Facility | None | $34.67 | $107.15 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $1,230.27 | Professional | None | $107.15 | $158.49 | $1,230.27 |
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 $114.82 Median $165.96 Typical High $239.88 | Professional | None | $114.82 | $165.96 | $239.88 |
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 $50.12 Median $72.44 Typical High $117.49 | Facility | 52 · Reduced service | $50.12 | $72.44 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $28.84 Typical High $46.77 | Facility | 53 · Discontinued | $20.42 | $28.84 | $46.77 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $75.86 Median $107.15 Typical High $173.78 | Facility | 54 · Surgery only | $75.86 | $107.15 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $34.67 | Facility | 55 · Aftercare only | $15.14 | $21.38 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.45 Typical High $23.44 | Facility | 56 · Pre-op care only | $10.00 | $14.45 | $23.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $100.00 Typical High $162.18 | Facility | 78 · Unplanned return to OR | $70.79 | $100.00 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $70.79 Typical High $81.28 | Professional | 52 · Reduced service | $50.12 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.18 Typical High $32.36 | Professional | 53 · Discontinued | $20.42 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $75.86 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $15.14 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.13 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.00 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $97.72 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $70.79 | $97.72 | $112.20 |
Where Kentucky sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 49th of 51
$141
WI $468TX $129
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.