How much rates vary
Facilitymedian $537 · 10th to 90th $331 to $2,239Professionalmedian $813 · 10th to 90th $457 to $1,259
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 $512.86 Median $537.03 Typical High $1,071.52 | Facility | None | $512.86 | $537.03 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $933.25 | Professional | None | $501.19 | $537.03 | $933.25 |
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 $446.68 Median $891.25 Typical High $1,258.93 | Professional | None | $446.68 | $891.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $1,348.96 Typical High $1,862.09 | Professional | 50 · Both sides | $660.69 | $1,348.96 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $707.95 | Facility | None | $380.19 | $457.09 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $741.31 | Professional | None | $446.68 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $363.08 Typical High $1,071.52 | Facility | None | $34.67 | $363.08 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $5,623.41 | Professional | None | $457.09 | $676.08 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $416.87 | Professional | None | $33.11 | $33.11 | $416.87 |
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 $616.60 Median $933.25 Typical High $1,148.15 | Professional | None | $616.60 | $933.25 | $1,148.15 |
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 $251.19 Median $269.15 Typical High $537.03 | Facility | 52 · Reduced service | $251.19 | $269.15 | $537.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $213.80 | Facility | 53 · Discontinued | $102.33 | $107.15 | $213.80 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $812.83 | Facility | 54 · Surgery only | $380.19 | $407.38 | $812.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $162.18 | Facility | 55 · Aftercare only | $75.86 | $81.28 | $162.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $107.15 | Facility | 56 · Pre-op care only | $51.29 | $53.70 | $107.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $758.58 | Facility | 78 · Unplanned return to OR | $354.81 | $380.19 | $758.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $263.03 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $467.74 | Professional | 54 · Surgery only | $371.54 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $93.33 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $436.52 |
Where Kentucky sits
The same service costs 6.2 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· 27th of 51
$741
AK $1,995UT $324
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.