How much rates vary
Facilitymedian $170 · 10th to 90th $89 to $1,778Professionalmedian $158 · 10th to 90th $110 to $219
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 $109.65 Median $169.82 Typical High $851.14 | Facility | None | $109.65 | $169.82 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $229.09 | Professional | None | $109.65 | $169.82 | $229.09 |
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 $107.15 Median $141.25 Typical High $213.80 | Professional | None | $107.15 | $141.25 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $173.78 Typical High $218.78 | Facility | None | $120.23 | $173.78 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $199.53 | Professional | None | $107.15 | $169.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $151.36 Typical High $190.55 | Facility | None | $34.67 | $151.36 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $977.24 | Professional | None | $123.03 | $190.55 | $977.24 |
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 $173.78 Typical High $275.42 | Professional | None | $117.49 | $173.78 | $275.42 |
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 $54.95 Median $83.18 Typical High $95.50 | Facility | 52 · Reduced service | $54.95 | $83.18 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.39 Median $33.88 Typical High $38.90 | Facility | 53 · Discontinued | $22.39 | $33.88 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $125.89 Typical High $144.54 | Facility | 54 · Surgery only | $83.18 | $125.89 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $25.12 Typical High $28.84 | Facility | 55 · Aftercare only | $16.60 | $25.12 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.98 Typical High $19.05 | Facility | 56 · Pre-op care only | $10.96 | $16.98 | $19.05 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $117.49 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $77.62 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $83.18 Typical High $95.50 | Professional | 52 · Reduced service | $54.95 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $33.11 Typical High $38.90 | Professional | 53 · Discontinued | $22.39 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $125.89 Typical High $144.54 | Professional | 54 · Surgery only | $83.18 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.12 Typical High $28.84 | Professional | 55 · Aftercare only | $16.60 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.60 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.96 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $117.49 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $77.62 | $117.49 | $134.90 |
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· 49th of 51
$158
AK $525MD $151
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.