How much rates vary
Facilitymedian $339 · 10th to 90th $224 to $2,512Professionalmedian $282 · 10th to 90th $204 to $447
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 $257.04 Median $309.03 Typical High $851.14 | Facility | None | $257.04 | $309.03 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $338.84 | Professional | None | $245.47 | $302.00 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $346.74 | Professional | None | $194.98 | $234.42 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $354.81 Typical High $512.86 | Professional | 50 · Both sides | $295.12 | $354.81 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $354.81 | Facility | None | $223.87 | $229.09 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $371.54 | Professional | None | $218.78 | $316.23 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $218.78 Typical High $398.11 | Facility | None | $34.67 | $218.78 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $1,778.28 | Professional | None | $229.09 | $288.40 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $123.03 | Professional | None | $33.11 | $33.11 | $123.03 |
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 $239.88 Median $288.40 Typical High $436.52 | Professional | None | $239.88 | $288.40 | $436.52 |
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 $128.82 Median $154.88 Typical High $169.82 | Facility | 52 · Reduced service | $128.82 | $154.88 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $63.10 Typical High $67.61 | Facility | 53 · Discontinued | $51.29 | $63.10 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $234.42 Typical High $251.19 | Facility | 54 · Surgery only | $190.55 | $234.42 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $46.77 Typical High $50.12 | Facility | 55 · Aftercare only | $38.02 | $46.77 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.90 Typical High $33.88 | Facility | 56 · Pre-op care only | $25.70 | $30.90 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $218.78 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $177.83 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $128.82 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $51.29 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $223.87 Typical High $245.47 | Professional | 54 · Surgery only | $190.55 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $38.02 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $208.93 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $177.83 | $208.93 | $229.09 |
Where Kentucky sits
The same service costs 5.2 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· 44th of 51
$282
AK $1,000UT $191
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.