How much rates vary
Facilitymedian $1,380 · 10th to 90th $288 to $3,890Professionalmedian $263 · 10th to 90th $186 to $372
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 $218.78 Median $302.00 Typical High $851.14 | Facility | None | $218.78 | $302.00 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $363.08 | Professional | None | $218.78 | $288.40 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $338.84 | Professional | None | $181.97 | $239.88 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $1,122.02 | Facility | None | $204.17 | $331.13 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $331.13 | Professional | None | $186.21 | $263.03 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $758.58 Typical High $1,659.59 | Facility | None | $354.81 | $758.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $1,584.89 | Professional | None | $213.80 | $281.84 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $93.33 | Professional | None | $33.11 | $33.11 | $93.33 |
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 $234.42 Median $309.03 Typical High $407.38 | Professional | None | $234.42 | $309.03 | $407.38 |
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 $109.65 Median $144.54 Typical High $181.97 | Facility | 52 · Reduced service | $109.65 | $144.54 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $57.54 Typical High $72.44 | Facility | 53 · Discontinued | $43.65 | $57.54 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $165.96 Median $213.80 Typical High $275.42 | Facility | 54 · Surgery only | $165.96 | $213.80 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.11 Median $43.65 Typical High $54.95 | Facility | 55 · Aftercare only | $33.11 | $43.65 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.84 Typical High $36.31 | Facility | 56 · Pre-op care only | $21.88 | $28.84 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $199.53 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $154.88 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $141.25 Typical High $181.97 | Professional | 52 · Reduced service | $109.65 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $56.23 Typical High $72.44 | Professional | 53 · Discontinued | $43.65 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $213.80 Typical High $275.42 | Professional | 54 · Surgery only | $165.96 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $42.66 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.18 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.88 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $199.53 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $154.88 | $199.53 | $257.04 |
Where Kentucky sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 46th of 51
$263
AK $933UT $219
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.