How much rates vary
Facilitymedian $851 · 10th to 90th $158 to $2,818Professionalmedian $295 · 10th to 90th $219 to $468
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 $263.03 Median $323.59 Typical High $851.14 | Facility | None | $263.03 | $323.59 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $416.87 | Professional | None | $263.03 | $309.03 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $218.78 Median $269.15 Typical High $346.74 | Professional | None | $218.78 | $269.15 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $398.11 Typical High $524.81 | Professional | 50 · Both sides | $331.13 | $398.11 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $323.59 | Facility | None | $173.78 | $281.84 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $467.74 | Professional | None | $275.42 | $380.19 | $467.74 |
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 $288.40 Median $346.74 Typical High $1,949.84 | Professional | None | $288.40 | $346.74 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $134.90 | Professional | None | $33.11 | $33.11 | $134.90 |
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 $263.03 Median $331.13 Typical High $524.81 | Professional | None | $263.03 | $331.13 | $524.81 |
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 $128.82 Median $162.18 Typical High $186.21 | Facility | 52 · Reduced service | $128.82 | $162.18 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $52.48 Median $64.57 Typical High $74.13 | Facility | 53 · Discontinued | $52.48 | $64.57 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $194.98 Median $239.88 Typical High $275.42 | Facility | 54 · Surgery only | $194.98 | $239.88 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $48.98 Typical High $54.95 | Facility | 55 · Aftercare only | $38.90 | $48.98 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.30 Median $32.36 Typical High $37.15 | Facility | 56 · Pre-op care only | $26.30 | $32.36 | $37.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $223.87 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $181.97 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $128.82 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $69.18 | Professional | 53 · Discontinued | $52.48 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $181.97 | $208.93 | $245.47 |
Where Kentucky sits
The same service costs 5.8 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
$302
AK $1,259UT $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.