How much rates vary
Facilitymedian $2,291 · 10th to 90th $355 to $9,772Professionalmedian $380 · 10th to 90th $302 to $1,072
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 $316.23 Median $354.81 Typical High $891.25 | Facility | None | $316.23 | $354.81 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $416.87 | Professional | None | $302.00 | $354.81 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $1,071.52 | Professional | None | $295.12 | $371.54 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $549.54 Typical High $2,818.38 | Facility | None | $323.59 | $549.54 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $575.44 | Professional | None | $346.74 | $478.63 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,995.26 Typical High $2,290.87 | Facility | None | $588.84 | $1,995.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $2,691.53 | Professional | None | $354.81 | $457.09 | $2,691.53 |
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 $398.11 Typical High $707.95 | Professional | None | $323.59 | $398.11 | $707.95 |
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 $158.49 Median $177.83 Typical High $257.04 | Facility | 52 · Reduced service | $158.49 | $177.83 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $70.79 Typical High $102.33 | Facility | 53 · Discontinued | $63.10 | $70.79 | $102.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $263.03 Typical High $389.05 | Facility | 54 · Surgery only | $234.42 | $263.03 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $53.70 Typical High $77.62 | Facility | 55 · Aftercare only | $46.77 | $53.70 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $35.48 Typical High $51.29 | Facility | 56 · Pre-op care only | $31.62 | $35.48 | $51.29 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $245.47 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $218.78 | $245.47 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $177.83 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $60.26 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $263.03 Typical High $302.00 | Professional | 54 · Surgery only | $223.87 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $44.67 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $35.48 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $245.47 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $208.93 | $245.47 | $281.84 |
Where Kentucky sits
The same service costs 3.8 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· 49th of 51
$407
AK $1,349UT $355
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.