How much rates vary
Facilitymedian $151 · 10th to 90th $87 to $1,380Professionalmedian $138 · 10th to 90th $102 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 $102.33 Median $144.54 Typical High $416.87 | Facility | None | $102.33 | $144.54 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $223.87 | Professional | None | $102.33 | $128.82 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $208.93 | Professional | None | $112.20 | $134.90 | $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 $95.50 Median $117.49 Typical High $162.18 | Professional | None | $95.50 | $117.49 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $169.82 | Facility | None | $93.33 | $114.82 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $199.53 | Professional | None | $138.04 | $151.36 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $89.13 Typical High $691.83 | Facility | None | $34.67 | $89.13 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $758.58 | Professional | None | $117.49 | $162.18 | $758.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $102.33 | Professional | None | $33.11 | $33.11 | $102.33 |
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 $134.90 Median $173.78 Typical High $234.42 | Professional | None | $134.90 | $173.78 | $234.42 |
13 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 $51.29 Median $61.66 Typical High $104.71 | Facility | 52 · Reduced service | $51.29 | $61.66 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $25.12 Typical High $41.69 | Facility | 53 · Discontinued | $20.42 | $25.12 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $75.86 Median $93.33 Typical High $158.49 | Facility | 54 · Surgery only | $75.86 | $93.33 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $18.62 Typical High $31.62 | Facility | 55 · Aftercare only | $15.14 | $18.62 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.59 Typical High $20.89 | Facility | 56 · Pre-op care only | $10.23 | $12.59 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $87.10 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $70.79 | $87.10 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $51.29 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $20.42 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $93.33 Typical High $109.65 | Professional | 54 · Surgery only | $75.86 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $15.14 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.23 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $87.10 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $70.79 | $87.10 | $102.33 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | GC · Resident with teaching physician | $131.83 | $131.83 | $131.83 |
Where Kentucky sits
The same service costs 3.9 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· 49th of 51
$138
AK $501FL $129
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.