How much rates vary
Facilitymedian $851 · 10th to 90th $158 to $2,818Professionalmedian $355 · 10th to 90th $263 to $550
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 $302.00 Median $380.19 Typical High $851.14 | Facility | None | $302.00 | $380.19 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $549.54 | Professional | None | $302.00 | $371.54 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $436.52 | Professional | None | $263.03 | $316.23 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $478.63 Typical High $660.69 | Professional | 50 · Both sides | $389.05 | $478.63 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $323.59 Typical High $380.19 | Facility | None | $173.78 | $323.59 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $549.54 | Professional | None | $363.08 | $446.68 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $398.11 Typical High $1,318.26 | Facility | None | $147.91 | $398.11 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $2,290.87 | Professional | None | $338.84 | $407.38 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $141.25 | Professional | None | $33.11 | $33.11 | $141.25 |
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 $309.03 Median $389.05 Typical High $616.60 | Professional | None | $309.03 | $389.05 | $616.60 |
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 $151.36 Median $186.21 Typical High $213.80 | Facility | 52 · Reduced service | $151.36 | $186.21 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $75.86 Typical High $87.10 | Facility | 53 · Discontinued | $60.26 | $75.86 | $87.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $229.09 Median $281.84 Typical High $323.59 | Facility | 54 · Surgery only | $229.09 | $281.84 | $323.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $45.71 Median $56.23 Typical High $64.57 | Facility | 55 · Aftercare only | $45.71 | $56.23 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.02 Typical High $42.66 | Facility | 56 · Pre-op care only | $30.20 | $38.02 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $263.03 Typical High $302.00 | Facility | 78 · Unplanned return to OR | $213.80 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $151.36 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $60.26 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $229.09 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $245.47 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $213.80 | $245.47 | $288.40 |
Where Kentucky sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 46th of 51
$363
AK $1,479UT $288
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.