How much rates vary
Facilitymedian $398 · 10th to 90th $123 to $3,548Professionalmedian $174 · 10th to 90th $110 to $251
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 $123.03 Median $208.93 Typical High $851.14 | Facility | None | $123.03 | $208.93 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $263.03 | Professional | None | $123.03 | $204.17 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $107.15 Median $169.82 Typical High $223.87 | Professional | None | $107.15 | $169.82 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $186.21 Typical High $275.42 | Facility | None | $117.49 | $186.21 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $186.21 | Professional | None | $104.71 | $147.91 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $199.53 Typical High $398.11 | Facility | None | $34.67 | $199.53 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $1,096.48 | Professional | None | $120.23 | $208.93 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $50.12 | Professional | None | $33.11 | $33.11 | $50.12 |
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 $134.90 Median $194.98 Typical High $269.15 | Professional | None | $134.90 | $194.98 | $269.15 |
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 $61.66 Median $102.33 Typical High $131.83 | Facility | 52 · Reduced service | $61.66 | $102.33 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $40.74 Typical High $53.70 | Facility | 53 · Discontinued | $24.55 | $40.74 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $151.36 Typical High $199.53 | Facility | 54 · Surgery only | $93.33 | $151.36 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $39.81 | Facility | 55 · Aftercare only | $18.62 | $30.20 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $20.42 Typical High $26.30 | Facility | 56 · Pre-op care only | $12.30 | $20.42 | $26.30 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $141.25 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $87.10 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $102.33 Typical High $131.83 | Professional | 52 · Reduced service | $61.66 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $40.74 Typical High $53.70 | Professional | 53 · Discontinued | $24.55 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $93.33 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $18.62 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.30 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $141.25 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $87.10 | $141.25 | $186.21 |
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· 44th of 51
$174
AK $525DC $158
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.