How much rates vary
Facilitymedian $513 · 10th to 90th $100 to $1,380Professionalmedian $631 · 10th to 90th $457 to $977
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 $416.87 Median $575.44 Typical High $707.95 | Facility | None | $416.87 | $575.44 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $707.95 | Professional | None | $416.87 | $575.44 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $467.74 Median $588.84 Typical High $776.25 | Professional | None | $467.74 | $588.84 | $776.25 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $389.05 Typical High $524.81 | Facility | None | $169.82 | $389.05 | $524.81 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $724.44 | Professional | None | $416.87 | $588.84 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $151.36 Typical High $758.58 | Facility | None | $34.67 | $151.36 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $3,715.35 | Professional | None | $457.09 | $707.95 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $436.52 | Professional | None | $33.11 | $33.11 | $436.52 |
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 $575.44 Median $758.58 Typical High $1,047.13 | Professional | None | $575.44 | $758.58 | $1,047.13 |
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 $208.93 Median $288.40 Typical High $354.81 | Facility | 52 · Reduced service | $208.93 | $288.40 | $354.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $83.18 Median $114.82 Typical High $141.25 | Facility | 53 · Discontinued | $83.18 | $114.82 | $141.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $316.23 Median $436.52 Typical High $537.03 | Facility | 54 · Surgery only | $316.23 | $436.52 | $537.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $63.10 Median $87.10 Typical High $107.15 | Facility | 55 · Aftercare only | $63.10 | $87.10 | $107.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $41.69 Median $57.54 Typical High $70.79 | Facility | 56 · Pre-op care only | $41.69 | $57.54 | $70.79 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $407.38 Typical High $501.19 | Facility | 78 · Unplanned return to OR | $295.12 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $288.40 Typical High $354.81 | Professional | 52 · Reduced service | $208.93 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $83.18 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $436.52 Typical High $537.03 | Professional | 54 · Surgery only | $316.23 | $436.52 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $87.10 Typical High $107.15 | Professional | 55 · Aftercare only | $63.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $41.69 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $407.38 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $295.12 | $407.38 | $501.19 |
Where Kentucky sits
The same service costs 3.6 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· 42nd of 51
$631
AK $1,950MD $537
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.