How much rates vary
Facilitymedian $407 · 10th to 90th $229 to $2,512Professionalmedian $537 · 10th to 90th $251 to $832
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 $281.84 Median $302.00 Typical High $891.25 | Facility | None | $281.84 | $302.00 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $676.08 | Professional | None | $275.42 | $302.00 | $676.08 |
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 $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 $223.87 Median $549.54 Typical High $691.83 | Professional | None | $223.87 | $549.54 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $831.76 Typical High $1,047.13 | Professional | 50 · Both sides | $338.84 | $831.76 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $251.19 Typical High $389.05 | Facility | None | $218.78 | $251.19 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $407.38 | Professional | None | $269.15 | $346.74 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $407.38 Typical High $2,187.76 | Facility | None | $194.98 | $407.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $489.78 Typical High $3,548.13 | Professional | None | $251.19 | $489.78 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $263.03 | Professional | None | $33.11 | $33.11 | $263.03 |
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 $371.54 Median $616.60 Typical High $758.58 | Professional | None | $371.54 | $616.60 | $758.58 |
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 $141.25 Median $151.36 Typical High $331.13 | Facility | 52 · Reduced service | $141.25 | $151.36 | $331.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $134.90 | Facility | 53 · Discontinued | $56.23 | $60.26 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $501.19 | Facility | 54 · Surgery only | $208.93 | $223.87 | $501.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $100.00 | Facility | 55 · Aftercare only | $41.69 | $44.67 | $100.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $66.07 | Facility | 56 · Pre-op care only | $28.18 | $30.20 | $66.07 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $467.74 | Facility | 78 · Unplanned return to OR | $194.98 | $208.93 | $467.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $147.91 Typical High $186.21 | Professional | 52 · Reduced service | $138.04 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $74.13 | Professional | 53 · Discontinued | $54.95 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $208.93 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $56.23 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $37.15 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $204.17 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $194.98 | $204.17 | $257.04 |
Where Kentucky sits
The same service costs 5.0 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· 19th of 51
$537
AK $1,096UT $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.