How much rates vary
Facilitymedian $427 · 10th to 90th $107 to $3,548Professionalmedian $148 · 10th to 90th $93 to $209
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 $107.15 Median $173.78 Typical High $851.14 | Facility | None | $107.15 | $173.78 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $218.78 | Professional | None | $107.15 | $165.96 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $190.55 | Professional | None | $91.20 | $147.91 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $213.80 | Facility | None | $100.00 | $162.18 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $162.18 | Professional | None | $91.20 | $125.89 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $158.49 Typical High $524.81 | Facility | None | $34.67 | $158.49 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $912.01 | Professional | None | $102.33 | $169.82 | $912.01 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | None | $33.11 | $33.11 | $44.67 |
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 $114.82 Median $162.18 Typical High $213.80 | Professional | None | $114.82 | $162.18 | $213.80 |
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 $52.48 Median $83.18 Typical High $109.65 | Facility | 52 · Reduced service | $52.48 | $83.18 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $33.88 Typical High $43.65 | Facility | 53 · Discontinued | $21.38 | $33.88 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $125.89 Typical High $165.96 | Facility | 54 · Surgery only | $79.43 | $125.89 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $25.12 Typical High $33.11 | Facility | 55 · Aftercare only | $15.85 | $25.12 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.60 Typical High $21.88 | Facility | 56 · Pre-op care only | $10.72 | $16.60 | $21.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $117.49 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $74.13 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $83.18 Typical High $109.65 | Professional | 52 · Reduced service | $52.48 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $21.38 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $125.89 Typical High $165.96 | Professional | 54 · Surgery only | $79.43 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.12 Typical High $33.11 | Professional | 55 · Aftercare only | $15.85 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.60 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.72 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $117.49 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $74.13 | $117.49 | $154.88 |
Where Kentucky sits
The same service costs 3.4 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· 42nd of 51
$148
AK $447FL $132
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.