How much rates vary
Facilitymedian $603 · 10th to 90th $245 to $4,467Professionalmedian $295 · 10th to 90th $195 to $490
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 $245.47 Median $371.54 Typical High $851.14 | Facility | None | $245.47 | $371.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $416.87 | Professional | None | $245.47 | $354.81 | $416.87 |
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 $186.21 Median $229.09 Typical High $323.59 | Professional | None | $186.21 | $229.09 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $338.84 Typical High $489.78 | Professional | 50 · Both sides | $281.84 | $338.84 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $380.19 | Facility | None | $181.97 | $302.00 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $354.81 | Professional | None | $213.80 | $302.00 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $288.40 Typical High $851.14 | Facility | None | $34.67 | $288.40 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $3,630.78 | Professional | None | $218.78 | $338.84 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $93.33 | Professional | None | $33.11 | $33.11 | $93.33 |
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 $218.78 Median $316.23 Typical High $478.63 | Professional | None | $218.78 | $316.23 | $478.63 |
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 $123.03 Median $186.21 Typical High $338.84 | Facility | 52 · Reduced service | $123.03 | $186.21 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $74.13 Typical High $134.90 | Facility | 53 · Discontinued | $48.98 | $74.13 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $181.97 Median $281.84 Typical High $512.86 | Facility | 54 · Surgery only | $181.97 | $281.84 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $36.31 Median $56.23 Typical High $102.33 | Facility | 55 · Aftercare only | $36.31 | $56.23 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $24.55 Median $37.15 Typical High $67.61 | Facility | 56 · Pre-op care only | $24.55 | $37.15 | $67.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $263.03 Typical High $478.63 | Facility | 78 · Unplanned return to OR | $169.82 | $263.03 | $478.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $123.03 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $48.98 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $269.15 Typical High $288.40 | Professional | 54 · Surgery only | $181.97 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $36.31 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $24.55 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $251.19 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $169.82 | $251.19 | $269.15 |
Where Kentucky sits
The same service costs 3.9 times more in Wyoming 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· 46th of 51
$309
WY $1,096UT $282
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.