How much rates vary
Facilitymedian $380 · 10th to 90th $107 to $3,890Professionalmedian $195 · 10th to 90th $141 to $355
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 $169.82 Median $208.93 Typical High $851.14 | Facility | None | $169.82 | $208.93 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $251.19 | Professional | None | $165.96 | $194.98 | $251.19 |
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 $141.25 Median $190.55 Typical High $354.81 | Professional | None | $141.25 | $190.55 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $147.91 Typical High $208.93 | Facility | None | $114.82 | $147.91 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $257.04 | Professional | None | $141.25 | $213.80 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $107.15 Typical High $691.83 | Facility | None | $34.67 | $107.15 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $2,041.74 | Professional | None | $158.49 | $229.09 | $2,041.74 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $323.59 | Professional | None | $158.49 | $229.09 | $323.59 |
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 $85.11 Median $104.71 Typical High $190.55 | Facility | 52 · Reduced service | $85.11 | $104.71 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $41.69 Typical High $75.86 | Facility | 53 · Discontinued | $33.88 | $41.69 | $75.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $288.40 | Facility | 54 · Surgery only | $128.82 | $158.49 | $288.40 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $57.54 | Facility | 55 · Aftercare only | $25.70 | $31.62 | $57.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.89 Typical High $38.02 | Facility | 56 · Pre-op care only | $16.98 | $20.89 | $38.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $147.91 Typical High $269.15 | Facility | 78 · Unplanned return to OR | $120.23 | $147.91 | $269.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $83.18 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.90 Typical High $47.86 | Professional | 53 · Discontinued | $33.11 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $177.83 | Professional | 54 · Surgery only | $125.89 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $25.12 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.60 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $134.90 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $117.49 | $134.90 | $165.96 |
Where Kentucky sits
The same service costs 4.9 times more in Oklahoma 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· 47th of 51
$195
OK $891FL $182
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.