How much rates vary
Facilitymedian $955 · 10th to 90th $204 to $6,918Professionalmedian $309 · 10th to 90th $214 to $468
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 $204.17 Median $331.13 Typical High $691.83 | Facility | None | $204.17 | $331.13 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $562.34 | Professional | None | $204.17 | $323.59 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $331.13 Typical High $537.03 | Professional | None | $125.89 | $331.13 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $398.11 | Professional | None | $213.80 | $288.40 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $316.23 Typical High $549.54 | Facility | None | $223.87 | $316.23 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $489.78 | Professional | None | $269.15 | $346.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $467.74 Typical High $1,862.09 | Facility | None | $371.54 | $467.74 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $1,862.09 | Professional | None | $229.09 | $363.08 | $1,862.09 |
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 $245.47 Median $338.84 Typical High $537.03 | Professional | None | $245.47 | $338.84 | $537.03 |
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 $102.33 Median $162.18 Typical High $181.97 | Facility | 52 · Reduced service | $102.33 | $162.18 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $64.57 Typical High $72.44 | Facility | 53 · Discontinued | $41.69 | $64.57 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $239.88 Typical High $269.15 | Facility | 54 · Surgery only | $154.88 | $239.88 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $54.95 | Facility | 55 · Aftercare only | $30.90 | $47.86 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $36.31 | Facility | 56 · Pre-op care only | $20.42 | $32.36 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $223.87 Typical High $251.19 | Facility | 78 · Unplanned return to OR | $144.54 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $158.49 Typical High $181.97 | Professional | 52 · Reduced service | $102.33 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $41.69 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $239.88 Typical High $269.15 | Professional | 54 · Surgery only | $154.88 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $54.95 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $20.42 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $223.87 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $144.54 | $223.87 | $251.19 |
Where Kentucky sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$316
AK $1,000UT $302
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.