How much rates vary
Facilitymedian $204 · 10th to 90th $89 to $1,778Professionalmedian $186 · 10th to 90th $132 to $309
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 $165.96 Median $204.17 Typical High $851.14 | Facility | None | $165.96 | $204.17 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $257.04 | Professional | None | $162.18 | $190.55 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $128.82 Median $154.88 Typical High $281.84 | Professional | None | $128.82 | $154.88 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $181.97 Typical High $288.40 | Facility | None | $165.96 | $181.97 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $295.12 | Professional | None | $194.98 | $239.88 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $331.13 | Facility | None | $34.67 | $154.88 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $1,659.59 | Professional | None | $181.97 | $229.09 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $87.10 | Professional | None | $33.11 | $33.11 | $87.10 |
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 $177.83 Median $223.87 Typical High $338.84 | Professional | None | $177.83 | $223.87 | $338.84 |
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 $81.28 Median $102.33 Typical High $154.88 | Facility | 52 · Reduced service | $81.28 | $102.33 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $40.74 Typical High $63.10 | Facility | 53 · Discontinued | $33.11 | $40.74 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $151.36 Typical High $234.42 | Facility | 54 · Surgery only | $123.03 | $151.36 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $30.20 Typical High $46.77 | Facility | 55 · Aftercare only | $24.55 | $30.20 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.42 Typical High $30.90 | Facility | 56 · Pre-op care only | $16.60 | $20.42 | $30.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $141.25 Typical High $218.78 | Facility | 78 · Unplanned return to OR | $114.82 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $93.33 Typical High $112.20 | Professional | 52 · Reduced service | $81.28 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $37.15 Typical High $44.67 | Professional | 53 · Discontinued | $33.11 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $141.25 Typical High $165.96 | Professional | 54 · Surgery only | $123.03 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $24.55 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $131.83 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $114.82 | $131.83 | $154.88 |
Where Kentucky sits
The same service costs 4.8 times more in Alaska than in Florida. 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
$186
AK $794FL $166
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.