How much rates vary
Facilitymedian $269 · 10th to 90th $87 to $1,380Professionalmedian $245 · 10th to 90th $186 to $417
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 $251.19 Median $269.15 Typical High $323.59 | Facility | None | $251.19 | $269.15 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $489.78 | Professional | None | $251.19 | $295.12 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $416.87 | Professional | None | $302.00 | $371.54 | $416.87 |
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 $181.97 Median $218.78 Typical High $275.42 | Professional | None | $181.97 | $218.78 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $269.15 Typical High $323.59 | Facility | None | $173.78 | $269.15 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $446.68 | Professional | None | $245.47 | $354.81 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $512.86 | Facility | None | $34.67 | $154.88 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $1,659.59 | Professional | None | $257.04 | $316.23 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $83.18 | Professional | None | $33.11 | $33.11 | $83.18 |
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 $223.87 Median $302.00 Typical High $489.78 | Professional | None | $223.87 | $302.00 | $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 $134.90 Typical High $162.18 | Facility | 52 · Reduced service | $123.03 | $134.90 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $50.12 Median $53.70 Typical High $64.57 | Facility | 53 · Discontinued | $50.12 | $53.70 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $186.21 Median $199.53 Typical High $239.88 | Facility | 54 · Surgery only | $186.21 | $199.53 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $37.15 Median $40.74 Typical High $47.86 | Facility | 55 · Aftercare only | $37.15 | $40.74 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.92 Typical High $32.36 | Facility | 56 · Pre-op care only | $25.12 | $26.92 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $186.21 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $173.78 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $141.25 Typical High $162.18 | Professional | 52 · Reduced service | $123.03 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $56.23 Typical High $64.57 | Professional | 53 · Discontinued | $50.12 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $239.88 | Professional | 54 · Surgery only | $186.21 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.18 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.12 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $223.87 |
Where Kentucky sits
The same service costs 5.6 times more in Alaska than in Texas. 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· 48th of 51
$245
AK $1,230TX $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.