How much rates vary
Facilitymedian $1,259 · 10th to 90th $191 to $3,981Professionalmedian $162 · 10th to 90th $120 to $302
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 $151.36 Median $245.47 Typical High $794.33 | Facility | None | $151.36 | $245.47 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $295.12 | Professional | None | $147.91 | $223.87 | $295.12 |
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 $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $190.55 | Professional | None | $107.15 | $128.82 | $190.55 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $194.98 Typical High $288.40 | Professional | 50 · Both sides | $158.49 | $194.98 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $275.42 | Facility | None | $131.83 | $213.80 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $218.78 | Professional | None | $147.91 | $186.21 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $204.17 Typical High $398.11 | Facility | None | $34.67 | $204.17 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $2,398.83 | Professional | None | $138.04 | $213.80 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $51.29 | Professional | None | $33.11 | $33.11 | $51.29 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $302.00 | Professional | None | $131.83 | $194.98 | $302.00 |
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 $75.86 Median $117.49 Typical High $223.87 | Facility | 52 · Reduced service | $75.86 | $117.49 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $46.77 Typical High $89.13 | Facility | 53 · Discontinued | $30.20 | $46.77 | $89.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $173.78 Typical High $338.84 | Facility | 54 · Surgery only | $114.82 | $173.78 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $35.48 Typical High $67.61 | Facility | 55 · Aftercare only | $22.91 | $35.48 | $67.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.44 Typical High $44.67 | Facility | 56 · Pre-op care only | $15.14 | $23.44 | $44.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $162.18 Typical High $316.23 | Facility | 78 · Unplanned return to OR | $107.15 | $162.18 | $316.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $112.20 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $44.67 Typical High $48.98 | Professional | 53 · Discontinued | $30.20 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.88 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $22.39 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.14 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $158.49 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $158.49 | $169.82 |
Where Kentucky sits
The same service costs 4.2 times more in Wyoming 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· 50th of 51
$170
WY $692UT $166
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.