How much rates vary
Facilitymedian $724 · 10th to 90th $100 to $2,818Professionalmedian $135 · 10th to 90th $100 to $214
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 $97.72 Median $128.82 Typical High $794.33 | Facility | None | $97.72 | $128.82 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $208.93 | Professional | None | $97.72 | $120.23 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $186.21 | Professional | None | $131.83 | $186.21 | $186.21 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 50 · Both sides | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $186.21 | Professional | None | $95.50 | $128.82 | $186.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $194.98 Typical High $275.42 | Professional | 50 · Both sides | $141.25 | $194.98 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $123.03 Typical High $173.78 | Facility | None | $104.71 | $123.03 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $177.83 | Professional | None | $123.03 | $134.90 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $102.33 Typical High $398.11 | Facility | None | $34.67 | $102.33 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $1,148.15 | Professional | None | $112.20 | $158.49 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $79.43 | Professional | None | $33.11 | $33.11 | $79.43 |
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 $125.89 Median $181.97 Typical High $229.09 | Professional | None | $125.89 | $181.97 | $229.09 |
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 $48.98 Median $56.23 Typical High $107.15 | Facility | 52 · Reduced service | $48.98 | $56.23 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $22.91 Typical High $42.66 | Facility | 53 · Discontinued | $19.50 | $22.91 | $42.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $72.44 Median $85.11 Typical High $162.18 | Facility | 54 · Surgery only | $72.44 | $85.11 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $32.36 | Facility | 55 · Aftercare only | $14.45 | $16.98 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.22 Typical High $21.38 | Facility | 56 · Pre-op care only | $9.77 | $11.22 | $21.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $79.43 Typical High $151.36 | Facility | 78 · Unplanned return to OR | $67.61 | $79.43 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $48.98 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.91 Typical High $25.70 | Professional | 53 · Discontinued | $19.50 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $85.11 Typical High $97.72 | Professional | 54 · Surgery only | $72.44 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $14.45 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.77 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $79.43 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $67.61 | $79.43 | $91.20 |
Where Kentucky sits
The same service costs 4.2 times more in Alaska 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· 42nd of 51
$138
AK $490FL $117
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.