How much rates vary
Facilitymedian $1,000 · 10th to 90th $214 to $3,802Professionalmedian $229 · 10th to 90th $166 to $339
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 $177.83 Median $275.42 Typical High $794.33 | Facility | None | $177.83 | $275.42 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $371.54 | Professional | None | $177.83 | $245.47 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $316.23 | Professional | None | $165.96 | $213.80 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $309.03 | Facility | None | $190.55 | $229.09 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $316.23 | Professional | None | $169.82 | $269.15 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $1,318.26 | Facility | None | $190.55 | $223.87 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $1,445.44 | Professional | None | $181.97 | $275.42 | $1,445.44 |
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 $181.97 Median $251.19 Typical High $426.58 | Professional | None | $181.97 | $251.19 | $426.58 |
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 $89.13 Median $123.03 Typical High $138.04 | Facility | 52 · Reduced service | $89.13 | $123.03 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $48.98 Typical High $54.95 | Facility | 53 · Discontinued | $35.48 | $48.98 | $54.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $181.97 Typical High $208.93 | Facility | 54 · Surgery only | $131.83 | $181.97 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $36.31 Typical High $41.69 | Facility | 55 · Aftercare only | $26.30 | $36.31 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $24.55 Typical High $27.54 | Facility | 56 · Pre-op care only | $17.78 | $24.55 | $27.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $169.82 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $123.03 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $89.13 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $35.48 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $131.83 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $26.30 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.78 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $123.03 | $169.82 | $194.98 |
Where Kentucky sits
The same service costs 3.9 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
$240
AK $851TX $219
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.