How much rates vary
Facilitymedian $1,148 · 10th to 90th $166 to $3,890Professionalmedian $155 · 10th to 90th $93 to $245
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 $109.65 Median $208.93 Typical High $794.33 | Facility | None | $109.65 | $208.93 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $251.19 | Professional | None | $109.65 | $190.55 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $91.20 Median $147.91 Typical High $245.47 | Professional | None | $91.20 | $147.91 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $165.96 Typical High $239.88 | Facility | None | $102.33 | $165.96 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $165.96 | Professional | None | $93.33 | $131.83 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $190.55 Typical High $398.11 | Facility | None | $34.67 | $190.55 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $1,288.25 | Professional | None | $107.15 | $194.98 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None | $33.11 | $33.11 | $45.71 |
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 $169.82 Typical High $239.88 | Professional | None | $114.82 | $169.82 | $239.88 |
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 $54.95 Median $97.72 Typical High $125.89 | Facility | 52 · Reduced service | $54.95 | $97.72 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $38.90 Typical High $50.12 | Facility | 53 · Discontinued | $21.88 | $38.90 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $147.91 Typical High $186.21 | Facility | 54 · Surgery only | $83.18 | $147.91 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $29.51 Typical High $37.15 | Facility | 55 · Aftercare only | $16.60 | $29.51 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $19.50 Typical High $25.12 | Facility | 56 · Pre-op care only | $10.96 | $19.50 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $138.04 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $77.62 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $91.20 Typical High $125.89 | Professional | 52 · Reduced service | $54.95 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $36.31 Typical High $50.12 | Professional | 53 · Discontinued | $21.88 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $134.90 Typical High $186.21 | Professional | 54 · Surgery only | $83.18 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.92 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $18.20 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.96 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $125.89 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $77.62 | $125.89 | $173.78 |
Where Kentucky sits
The same service costs 3.5 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· 43rd of 51
$155
AK $468DC $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.