How much rates vary
Facilitymedian $661 · 10th to 90th $98 to $2,818Professionalmedian $148 · 10th to 90th $98 to $219
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 $85.11 Median $147.91 Typical High $416.87 | Facility | None | $85.11 | $147.91 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $269.15 | Professional | None | $87.10 | $141.25 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $204.17 | Professional | None | $125.89 | $151.36 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $199.53 | Professional | None | $102.33 | $138.04 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $131.83 Typical High $169.82 | Facility | None | $93.33 | $131.83 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $199.53 | Professional | None | $112.20 | $141.25 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $1,318.26 | Facility | None | $112.20 | $165.96 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $851.14 | Professional | None | $95.50 | $169.82 | $851.14 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $263.03 | Professional | None | $131.83 | $177.83 | $263.03 |
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 $41.69 Median $64.57 Typical High $81.28 | Facility | 52 · Reduced service | $41.69 | $64.57 | $81.28 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $25.70 Typical High $32.36 | Facility | 53 · Discontinued | $16.98 | $25.70 | $32.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $95.50 Typical High $123.03 | Facility | 54 · Surgery only | $63.10 | $95.50 | $123.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $19.05 Typical High $24.55 | Facility | 55 · Aftercare only | $12.59 | $19.05 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.88 Typical High $16.22 | Facility | 56 · Pre-op care only | $8.51 | $12.88 | $16.22 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $89.13 Typical High $114.82 | Facility | 78 · Unplanned return to OR | $58.88 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $64.57 Typical High $74.13 | Professional | 52 · Reduced service | $41.69 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $16.98 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $95.50 Typical High $112.20 | Professional | 54 · Surgery only | $63.10 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $12.59 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.51 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $89.13 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $58.88 | $89.13 | $104.71 |
Where Kentucky sits
The same service costs 3.2 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· 46th of 51
$148
AK $427TX $132
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.