How much rates vary
Facilitymedian $186 · 10th to 90th $87 to $1,380Professionalmedian $166 · 10th to 90th $112 to $245
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 $114.82 Median $165.96 Typical High $208.93 | Facility | None | $114.82 | $165.96 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $208.93 | Professional | None | $114.82 | $186.21 | $208.93 |
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 $112.20 Median $165.96 Typical High $204.17 | Professional | None | $112.20 | $165.96 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $524.81 Typical High $933.25 | Facility | None | $123.03 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $204.17 | Professional | None | $123.03 | $173.78 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $263.03 | Facility | None | $34.67 | $154.88 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $1,122.02 | Professional | None | $125.89 | $208.93 | $1,122.02 |
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 $117.49 Median $199.53 Typical High $309.03 | Professional | None | $117.49 | $199.53 | $309.03 |
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 $57.54 Median $83.18 Typical High $104.71 | Facility | 52 · Reduced service | $57.54 | $83.18 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $33.88 Typical High $41.69 | Facility | 53 · Discontinued | $22.91 | $33.88 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $125.89 Typical High $158.49 | Facility | 54 · Surgery only | $85.11 | $125.89 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $25.12 Typical High $31.62 | Facility | 55 · Aftercare only | $16.98 | $25.12 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.60 Typical High $20.89 | Facility | 56 · Pre-op care only | $11.48 | $16.60 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $117.49 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $79.43 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $57.54 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $22.91 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $85.11 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $16.98 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.48 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $79.43 | $128.82 | $147.91 |
Where Kentucky sits
The same service costs 3.8 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
$166
AK $603MD $158
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.