How much rates vary
Facilitymedian $302 · 10th to 90th $87 to $1,380Professionalmedian $275 · 10th to 90th $191 to $437
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 $245.47 Median $302.00 Typical High $331.13 | Facility | None | $245.47 | $302.00 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $407.38 | Professional | None | $245.47 | $295.12 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $190.55 Median $234.42 Typical High $316.23 | Professional | None | $190.55 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $346.74 Typical High $467.74 | Professional | 50 · Both sides | $288.40 | $346.74 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $323.59 | Facility | None | $165.96 | $229.09 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $446.68 | Professional | None | $295.12 | $363.08 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $501.19 | Facility | None | $34.67 | $154.88 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $1,698.24 | Professional | None | $275.42 | $331.13 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $112.20 | Professional | None | $33.11 | $33.11 | $112.20 |
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 $239.88 Median $309.03 Typical High $489.78 | Professional | None | $239.88 | $309.03 | $489.78 |
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 $123.03 Median $151.36 Typical High $165.96 | Facility | 52 · Reduced service | $123.03 | $151.36 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $61.66 Typical High $66.07 | Facility | 53 · Discontinued | $48.98 | $61.66 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $186.21 Median $229.09 Typical High $245.47 | Facility | 54 · Surgery only | $186.21 | $229.09 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $48.98 | Facility | 55 · Aftercare only | $37.15 | $45.71 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.20 Typical High $33.11 | Facility | 56 · Pre-op care only | $24.55 | $30.20 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $213.80 Typical High $229.09 | Facility | 78 · Unplanned return to OR | $173.78 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $123.03 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $66.07 | Professional | 53 · Discontinued | $48.98 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $229.09 |
Where Kentucky sits
The same service costs 5.5 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
$275
AK $1,202UT $219
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.