How much rates vary
Facilitymedian $1,072 · 10th to 90th $331 to $3,802Professionalmedian $295 · 10th to 90th $229 to $468
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 $316.23 Median $338.84 Typical High $794.33 | Facility | None | $316.23 | $338.84 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $512.86 | Professional | None | $288.40 | $338.84 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $436.52 | Professional | None | $239.88 | $309.03 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $295.12 | Professional | None | $218.78 | $251.19 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $380.19 Typical High $436.52 | Professional | 50 · Both sides | $331.13 | $380.19 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $380.19 Typical High $501.19 | Facility | None | $275.42 | $380.19 | $501.19 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $426.58 | Professional | None | $295.12 | $323.59 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $1,862.09 | Facility | None | $331.13 | $478.63 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $1,621.81 | Professional | None | $275.42 | $309.03 | $1,621.81 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $489.78 | Professional | None | $257.04 | $295.12 | $489.78 |
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 $134.90 Median $165.96 Typical High $173.78 | Facility | 52 · Reduced service | $134.90 | $165.96 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $66.07 Typical High $70.79 | Facility | 53 · Discontinued | $53.70 | $66.07 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $263.03 | Facility | 54 · Surgery only | $204.17 | $245.47 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $52.48 | Facility | 55 · Aftercare only | $40.74 | $48.98 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.11 Typical High $34.67 | Facility | 56 · Pre-op care only | $26.92 | $33.11 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $229.09 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $190.55 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $61.66 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $218.78 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $52.48 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $229.09 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $213.80 | $229.09 | $245.47 |
Where Kentucky sits
The same service costs 5.8 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· 48th of 51
$295
AK $1,259UT $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.