How much rates vary
Facilitymedian $851 · 10th to 90th $204 to $3,802Professionalmedian $282 · 10th to 90th $209 to $427
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 $338.84 Typical High $794.33 | Facility | None | $204.17 | $338.84 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $467.74 | Professional | None | $204.17 | $316.23 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $389.05 | Professional | None | $208.93 | $269.15 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $275.42 Typical High $363.08 | Facility | None | $218.78 | $275.42 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $363.08 | Professional | None | $199.53 | $288.40 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $363.08 Typical High $1,659.59 | Facility | None | $245.47 | $363.08 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $1,862.09 | Professional | None | $223.87 | $354.81 | $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 $234.42 Median $316.23 Typical High $524.81 | Professional | None | $234.42 | $316.23 | $524.81 |
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 $158.49 Typical High $177.83 | Facility | 52 · Reduced service | $102.33 | $158.49 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $70.79 | Facility | 53 · Discontinued | $40.74 | $63.10 | $70.79 |
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 $53.70 | Facility | 55 · Aftercare only | $30.90 | $47.86 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $35.48 | Facility | 56 · Pre-op care only | $20.42 | $31.62 | $35.48 |
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 $154.88 Typical High $177.83 | Professional | 52 · Reduced service | $102.33 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $40.74 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $154.88 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $46.77 Typical High $53.70 | Professional | 55 · Aftercare only | $30.90 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.90 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.42 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $218.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $144.54 | $218.78 | $251.19 |
Where Kentucky sits
The same service costs 3.5 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
$288
AK $977MD $282
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.