How much rates vary
Facilitymedian $871 · 10th to 90th $191 to $2,818Professionalmedian $182 · 10th to 90th $123 to $339
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 $128.82 Median $190.55 Typical High $851.14 | Facility | None | $128.82 | $190.55 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $223.87 | Professional | None | $128.82 | $190.55 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $295.12 Median $1,659.59 Typical High $2,884.03 | Facility | None | $295.12 | $1,659.59 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $199.53 | Professional | None | $123.03 | $144.54 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $812.83 | Facility | None | $141.25 | $229.09 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $239.88 | Professional | None | $141.25 | $194.98 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $562.34 Typical High $1,318.26 | Facility | None | $239.88 | $562.34 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $1,659.59 | Professional | None | $147.91 | $223.87 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $83.18 | Professional | None | $33.11 | $33.11 | $83.18 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $380.19 | Professional | None | $151.36 | $245.47 | $380.19 |
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 $64.57 Median $95.50 Typical High $154.88 | Facility | 52 · Reduced service | $64.57 | $95.50 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $61.66 | Facility | 53 · Discontinued | $25.70 | $38.02 | $61.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $234.42 | Facility | 54 · Surgery only | $97.72 | $144.54 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $46.77 | Facility | 55 · Aftercare only | $19.50 | $28.84 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $30.90 | Facility | 56 · Pre-op care only | $12.88 | $19.05 | $30.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $218.78 | Facility | 78 · Unplanned return to OR | $91.20 | $134.90 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $64.57 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $25.70 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $169.82 | Professional | 54 · Surgery only | $97.72 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $33.88 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $158.49 |
Where Kentucky sits
The same service costs 4.2 times more in Alaska than in Virginia. 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
$186
AK $776VA $186
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.