How much rates vary
Facilitymedian $2,042 · 10th to 90th $550 to $8,128Professionalmedian $468 · 10th to 90th $355 to $776
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 $446.68 Median $549.54 Typical High $851.14 | Facility | None | $446.68 | $549.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $588.84 | Professional | None | $436.52 | $537.03 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $645.65 | Professional | None | $331.13 | $407.38 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $602.56 Typical High $954.99 | Professional | 50 · Both sides | $501.19 | $602.56 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $1,737.80 | Facility | None | $389.05 | $630.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $645.65 | Professional | None | $389.05 | $524.81 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,230.27 Typical High $2,511.89 | Facility | None | $660.69 | $1,230.27 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $3,548.13 | Professional | None | $407.38 | $501.19 | $3,548.13 |
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 $389.05 Median $478.63 Typical High $758.58 | Professional | None | $389.05 | $478.63 | $758.58 |
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 $223.87 Median $275.42 Typical High $338.84 | Facility | 52 · Reduced service | $223.87 | $275.42 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $134.90 | Facility | 53 · Discontinued | $89.13 | $109.65 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $338.84 Median $416.87 Typical High $501.19 | Facility | 54 · Surgery only | $338.84 | $416.87 | $501.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $67.61 Median $83.18 Typical High $100.00 | Facility | 55 · Aftercare only | $67.61 | $83.18 | $100.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $67.61 | Facility | 56 · Pre-op care only | $44.67 | $54.95 | $67.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $389.05 Typical High $467.74 | Facility | 78 · Unplanned return to OR | $316.23 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $338.84 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $316.23 | $371.54 | $407.38 |
Where Kentucky sits
The same service costs 6.5 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· 45th of 51
$501
AK $2,239UT $347
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.