How much rates vary
Facilitymedian $158 · 10th to 90th $89 to $1,479Professionalmedian $148 · 10th to 90th $93 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 $91.20 Median $154.88 Typical High $794.33 | Facility | None | $91.20 | $154.88 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $257.04 | Professional | None | $91.20 | $147.91 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $190.55 | Professional | None | $93.33 | $144.54 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $204.17 | Facility | None | $100.00 | $158.49 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $165.96 | Professional | None | $89.13 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $147.91 Typical High $181.97 | Facility | None | $34.67 | $147.91 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $891.25 | Professional | None | $102.33 | $169.82 | $891.25 |
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 $109.65 Median $169.82 Typical High $263.03 | Professional | None | $109.65 | $169.82 | $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 $44.67 Median $74.13 Typical High $85.11 | Facility | 52 · Reduced service | $44.67 | $74.13 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $29.51 Typical High $33.88 | Facility | 53 · Discontinued | $18.20 | $29.51 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $109.65 Typical High $128.82 | Facility | 54 · Surgery only | $67.61 | $109.65 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $21.88 Typical High $25.70 | Facility | 55 · Aftercare only | $13.49 | $21.88 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.79 Typical High $16.98 | Facility | 56 · Pre-op care only | $9.12 | $14.79 | $16.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $102.33 Typical High $120.23 | Facility | 78 · Unplanned return to OR | $63.10 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $74.13 Typical High $85.11 | Professional | 52 · Reduced service | $44.67 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $29.51 Typical High $33.88 | Professional | 53 · Discontinued | $18.20 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $109.65 Typical High $128.82 | Professional | 54 · Surgery only | $67.61 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.88 Typical High $25.70 | Professional | 55 · Aftercare only | $13.49 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.79 Typical High $16.98 | Professional | 56 · Pre-op care only | $9.12 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $102.33 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $63.10 | $102.33 | $120.23 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 50th of 51
$148
AK $490FL $138
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.