How much rates vary
Facilitymedian $257 · 10th to 90th $110 to $1,380Professionalmedian $229 · 10th to 90th $166 to $363
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 $169.82 Median $257.04 Typical High $549.54 | Facility | None | $169.82 | $257.04 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $457.09 | Professional | None | $169.82 | $257.04 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $380.19 | Professional | None | $239.88 | $263.03 | $380.19 |
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 $151.36 Median $218.78 Typical High $295.12 | Professional | None | $151.36 | $218.78 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $257.04 Typical High $338.84 | Facility | None | $181.97 | $257.04 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $389.05 | Professional | None | $218.78 | $281.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $239.88 Typical High $302.00 | Facility | None | $34.67 | $239.88 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $1,513.56 | Professional | None | $186.21 | $288.40 | $1,513.56 |
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 $181.97 Median $257.04 Typical High $416.87 | Professional | None | $181.97 | $257.04 | $416.87 |
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 $83.18 Median $128.82 Typical High $144.54 | Facility | 52 · Reduced service | $83.18 | $128.82 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $51.29 Typical High $57.54 | Facility | 53 · Discontinued | $33.88 | $51.29 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $190.55 Typical High $218.78 | Facility | 54 · Surgery only | $125.89 | $190.55 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $38.02 Typical High $43.65 | Facility | 55 · Aftercare only | $25.12 | $38.02 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.70 Typical High $28.84 | Facility | 56 · Pre-op care only | $16.98 | $25.70 | $28.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $177.83 Typical High $204.17 | Facility | 78 · Unplanned return to OR | $117.49 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $83.18 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $33.88 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $190.55 Typical High $218.78 | Professional | 54 · Surgery only | $125.89 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $38.02 Typical High $43.65 | Professional | 55 · Aftercare only | $25.12 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.98 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $177.83 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $117.49 | $177.83 | $204.17 |
Where Kentucky sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$229
AK $813MD $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.