How much rates vary
Facilitymedian $832 · 10th to 90th $302 to $3,890Professionalmedian $275 · 10th to 90th $209 to $525
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 $302.00 Median $398.11 Typical High $467.74 | Facility | None | $302.00 | $398.11 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $467.74 | Professional | None | $302.00 | $426.58 | $467.74 |
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 $208.93 Median $239.88 Typical High $331.13 | Professional | None | $208.93 | $239.88 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $363.08 Typical High $446.68 | Professional | 50 · Both sides | $316.23 | $363.08 | $446.68 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $131.83 Median $151.36 Typical High $186.21 | Professional | 62 · Two surgeons | $131.83 | $151.36 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $416.87 Typical High $1,737.80 | Facility | None | $263.03 | $416.87 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $436.52 | Professional | None | $288.40 | $371.54 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $1,318.26 | Facility | None | $34.67 | $794.33 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $2,187.76 | Professional | None | $269.15 | $407.38 | $2,187.76 |
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 $251.19 Median $389.05 Typical High $588.84 | Professional | None | $251.19 | $389.05 | $588.84 |
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 $151.36 Median $199.53 Typical High $234.42 | Facility | 52 · Reduced service | $151.36 | $199.53 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $81.28 Typical High $93.33 | Facility | 53 · Discontinued | $60.26 | $81.28 | $93.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $302.00 Typical High $354.81 | Facility | 54 · Surgery only | $223.87 | $302.00 | $354.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $60.26 Typical High $70.79 | Facility | 55 · Aftercare only | $44.67 | $60.26 | $70.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.20 Median $39.81 Typical High $46.77 | Facility | 56 · Pre-op care only | $30.20 | $39.81 | $46.77 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $281.84 Typical High $331.13 | Facility | 78 · Unplanned return to OR | $208.93 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $151.36 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $81.28 Typical High $93.33 | Professional | 53 · Discontinued | $60.26 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $223.87 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $44.67 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $40.74 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.20 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $208.93 | $288.40 | $331.13 |
Where Kentucky sits
The same service costs 5.5 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
$288
AK $1,585UT $288
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.