How much rates vary
Facilitymedian $1,000 · 10th to 90th $204 to $3,802Professionalmedian $214 · 10th to 90th $155 to $324
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 $162.18 Median $234.42 Typical High $489.78 | Facility | None | $162.18 | $234.42 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $389.05 | Professional | None | $162.18 | $229.09 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $281.84 | Professional | None | $138.04 | $204.17 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $281.84 | Facility | None | $173.78 | $229.09 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $346.74 | Professional | None | $213.80 | $251.19 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $288.40 Typical High $1,318.26 | Facility | None | $190.55 | $288.40 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $1,318.26 | Professional | None | $165.96 | $257.04 | $1,318.26 |
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 $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 $165.96 Median $234.42 Typical High $389.05 | Professional | None | $165.96 | $234.42 | $389.05 |
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 $81.28 Median $114.82 Typical High $128.82 | Facility | 52 · Reduced service | $81.28 | $114.82 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $45.71 Typical High $51.29 | Facility | 53 · Discontinued | $32.36 | $45.71 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $194.98 | Facility | 54 · Surgery only | $123.03 | $173.78 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $34.67 Typical High $38.90 | Facility | 55 · Aftercare only | $24.55 | $34.67 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.91 Typical High $25.70 | Facility | 56 · Pre-op care only | $16.22 | $22.91 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $162.18 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $114.82 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $81.28 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $32.36 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $123.03 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $24.55 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.22 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $114.82 | $158.49 | $181.97 |
Where Kentucky sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 49th of 51
$219
AK $776TX $214
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.