How much rates vary
Facilitymedian $158 · 10th to 90th $87 to $1,778Professionalmedian $135 · 10th to 90th $91 to $200
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 $165.96 Typical High $851.14 | Facility | None | $104.71 | $165.96 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $208.93 | Professional | None | $104.71 | $151.36 | $208.93 |
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 $91.20 Median $131.83 Typical High $173.78 | Professional | None | $91.20 | $131.83 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $151.36 Typical High $190.55 | Facility | None | $97.72 | $151.36 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $158.49 | Professional | None | $91.20 | $123.03 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $144.54 Typical High $169.82 | Facility | None | $34.67 | $144.54 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $891.25 | Professional | None | $102.33 | $162.18 | $891.25 |
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 $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 $114.82 Median $158.49 Typical High $218.78 | Professional | None | $114.82 | $158.49 | $218.78 |
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 $67.61 Typical High $104.71 | Facility | 52 · Reduced service | $52.48 | $67.61 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $26.92 Typical High $41.69 | Facility | 53 · Discontinued | $20.89 | $26.92 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $100.00 Typical High $154.88 | Facility | 54 · Surgery only | $77.62 | $100.00 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $19.95 Typical High $30.90 | Facility | 55 · Aftercare only | $15.85 | $19.95 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $20.89 | Facility | 56 · Pre-op care only | $10.47 | $13.49 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $93.33 Typical High $144.54 | Facility | 78 · Unplanned return to OR | $72.44 | $93.33 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $75.86 Typical High $104.71 | Professional | 52 · Reduced service | $52.48 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $30.90 Typical High $41.69 | Professional | 53 · Discontinued | $20.89 | $30.90 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $114.82 Typical High $154.88 | Professional | 54 · Surgery only | $77.62 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $22.91 Typical High $30.90 | Professional | 55 · Aftercare only | $15.85 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.14 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.47 | $15.14 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $107.15 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $72.44 | $107.15 | $144.54 |
Where Kentucky sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 47th of 51
$135
AK $437NJ $126
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.