How much rates vary
Facilitymedian $977 · 10th to 90th $363 to $2,818Professionalmedian $589 · 10th to 90th $457 to $851
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 $512.86 Median $524.81 Typical High $891.25 | Facility | None | $512.86 | $524.81 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $776.25 | Professional | None | $489.78 | $524.81 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | None | $478.63 | $478.63 | $489.78 |
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 $436.52 Median $588.84 Typical High $776.25 | Professional | None | $436.52 | $588.84 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $891.25 Typical High $1,174.90 | Professional | 50 · Both sides | $660.69 | $891.25 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $457.09 Typical High $676.08 | Facility | None | $363.08 | $457.09 | $676.08 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $741.31 | Professional | None | $407.38 | $602.56 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $354.81 Typical High $977.24 | Facility | None | $34.67 | $354.81 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $3,801.89 | Professional | None | $457.09 | $602.56 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $309.03 | Professional | None | $33.11 | $33.11 | $309.03 |
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 $549.54 Median $645.65 Typical High $851.14 | Professional | None | $549.54 | $645.65 | $851.14 |
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 $251.19 Median $263.03 Typical High $363.08 | Facility | 52 · Reduced service | $251.19 | $263.03 | $363.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $144.54 | Facility | 53 · Discontinued | $102.33 | $107.15 | $144.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $537.03 | Facility | 54 · Surgery only | $380.19 | $398.11 | $537.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $107.15 | Facility | 55 · Aftercare only | $75.86 | $79.43 | $107.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $72.44 | Facility | 56 · Pre-op care only | $51.29 | $52.48 | $72.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $371.54 Typical High $501.19 | Facility | 78 · Unplanned return to OR | $354.81 | $371.54 | $501.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $263.03 Typical High $309.03 | Professional | 52 · Reduced service | $245.47 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $123.03 | Professional | 53 · Discontinued | $97.72 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $371.54 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $93.33 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $61.66 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $426.58 |
Where Kentucky sits
The same service costs 6.2 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· 35th of 51
$589
AK $1,995UT $324
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.