How much rates vary
Facilitymedian $1,820 · 10th to 90th $468 to $7,244Professionalmedian $324 · 10th to 90th $240 to $589
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 $316.23 Median $467.74 Typical High $794.33 | Facility | None | $316.23 | $467.74 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $512.86 | Professional | None | $309.03 | $457.09 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $363.08 | Professional | None | $208.93 | $245.47 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $371.54 Typical High $549.54 | Professional | 50 · Both sides | $316.23 | $371.54 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $446.68 Typical High $1,737.80 | Facility | None | $239.88 | $446.68 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $457.09 | Professional | None | $281.84 | $389.05 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,258.93 Typical High $2,290.87 | Facility | None | $478.63 | $1,258.93 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $3,715.35 | Professional | None | $288.40 | $436.52 | $3,715.35 |
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 $239.88 Median $323.59 Typical High $602.56 | Professional | None | $239.88 | $323.59 | $602.56 |
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 $158.49 Median $234.42 Typical High $346.74 | Facility | 52 · Reduced service | $158.49 | $234.42 | $346.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $93.33 Typical High $138.04 | Facility | 53 · Discontinued | $63.10 | $93.33 | $138.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $354.81 Typical High $512.86 | Facility | 54 · Surgery only | $239.88 | $354.81 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $70.79 Typical High $102.33 | Facility | 55 · Aftercare only | $47.86 | $70.79 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $46.77 Typical High $69.18 | Facility | 56 · Pre-op care only | $31.62 | $46.77 | $69.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $331.13 Typical High $478.63 | Facility | 78 · Unplanned return to OR | $223.87 | $331.13 | $478.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $223.87 | $316.23 | $346.74 |
Where Kentucky sits
The same service costs 5.9 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· 48th of 51
$355
AK $1,698UT $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.