How much rates vary
Facilitymedian $178 · 10th to 90th $89 to $1,778Professionalmedian $148 · 10th to 90th $102 to $209
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 $102.33 Median $158.49 Typical High $794.33 | Facility | None | $102.33 | $158.49 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $229.09 | Professional | None | $102.33 | $158.49 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $208.93 | Professional | None | $141.25 | $173.78 | $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 $100.00 Median $131.83 Typical High $199.53 | Professional | None | $100.00 | $131.83 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $524.81 Typical High $933.25 | Facility | None | $112.20 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $186.21 | Professional | None | $112.20 | $158.49 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $181.97 | Facility | None | $34.67 | $75.86 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $912.01 | Professional | None | $114.82 | $177.83 | $912.01 |
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 $112.20 Median $162.18 Typical High $257.04 | Professional | None | $112.20 | $162.18 | $257.04 |
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 $51.29 Median $79.43 Typical High $89.13 | Facility | 52 · Reduced service | $51.29 | $79.43 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $31.62 Typical High $35.48 | Facility | 53 · Discontinued | $20.42 | $31.62 | $35.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $117.49 Typical High $134.90 | Facility | 54 · Surgery only | $77.62 | $117.49 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $26.92 | Facility | 55 · Aftercare only | $15.49 | $23.99 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.85 Typical High $17.78 | Facility | 56 · Pre-op care only | $10.23 | $15.85 | $17.78 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $109.65 Typical High $125.89 | Facility | 78 · Unplanned return to OR | $72.44 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $51.29 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $20.42 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $77.62 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $15.49 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.23 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $109.65 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $72.44 | $109.65 | $125.89 |
Where Kentucky sits
The same service costs 3.3 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· 49th of 51
$148
AK $490MD $148
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.