How much rates vary
Facilitymedian $1,072 · 10th to 90th $174 to $2,818Professionalmedian $145 · 10th to 90th $83 to $240
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 $104.71 Median $194.98 Typical High $794.33 | Facility | None | $104.71 | $194.98 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $245.47 | Professional | None | $104.71 | $194.98 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $229.09 | Professional | None | $114.82 | $114.82 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $181.97 | Professional | None | $79.43 | $141.25 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $158.49 Typical High $1,122.02 | Facility | None | $97.72 | $158.49 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $158.49 | Professional | None | $89.13 | $123.03 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $758.58 Typical High $1,318.26 | Facility | None | $173.78 | $758.58 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $1,047.13 | Professional | None | $102.33 | $194.98 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $257.04 | Professional | None | $112.20 | $173.78 | $257.04 |
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 $51.29 Median $97.72 Typical High $123.03 | Facility | 52 · Reduced service | $51.29 | $97.72 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $38.90 Typical High $48.98 | Facility | 53 · Discontinued | $20.89 | $38.90 | $48.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $144.54 Typical High $186.21 | Facility | 54 · Surgery only | $77.62 | $144.54 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $28.84 Typical High $37.15 | Facility | 55 · Aftercare only | $15.49 | $28.84 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $19.50 Typical High $24.55 | Facility | 56 · Pre-op care only | $10.47 | $19.50 | $24.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $134.90 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $72.44 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $97.72 Typical High $123.03 | Professional | 52 · Reduced service | $51.29 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $38.90 Typical High $48.98 | Professional | 53 · Discontinued | $20.89 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $77.62 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $28.84 Typical High $37.15 | Professional | 55 · Aftercare only | $15.49 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $19.50 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.47 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $134.90 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $72.44 | $134.90 | $173.78 |
Where Kentucky sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 49th of 51
$145
AK $447DC $135
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.