How much rates vary
Facilitymedian $427 · 10th to 90th $112 to $3,890Professionalmedian $141 · 10th to 90th $120 to $245
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 $154.88 Median $162.18 Typical High $851.14 | Facility | None | $154.88 | $162.18 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $199.53 | Professional | None | $147.91 | $162.18 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $147.91 | Professional | None | $104.71 | $125.89 | $147.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $190.55 Typical High $223.87 | Professional | 50 · Both sides | $158.49 | $190.55 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $138.04 Typical High $213.80 | Facility | None | $114.82 | $138.04 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $223.87 | Professional | None | $123.03 | $181.97 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $112.20 Typical High $398.11 | Facility | None | $34.67 | $112.20 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $2,290.87 | Professional | None | $131.83 | $147.91 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | None | $33.11 | $33.11 | $47.86 |
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 $144.54 Typical High $245.47 | Professional | None | $131.83 | $144.54 | $245.47 |
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 $77.62 Median $81.28 Typical High $208.93 | Facility | 52 · Reduced service | $77.62 | $81.28 | $208.93 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $85.11 | Facility | 53 · Discontinued | $30.90 | $32.36 | $85.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $120.23 Typical High $316.23 | Facility | 54 · Surgery only | $114.82 | $120.23 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $23.99 Typical High $63.10 | Facility | 55 · Aftercare only | $22.91 | $23.99 | $63.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.22 Typical High $42.66 | Facility | 56 · Pre-op care only | $15.49 | $16.22 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $112.20 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $107.15 | $112.20 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $32.36 Typical High $36.31 | Professional | 53 · Discontinued | $29.51 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $112.20 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.79 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $112.20 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $104.71 | $112.20 | $125.89 |
Where Kentucky sits
The same service costs 4.6 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· 47th of 51
$145
AK $603FL $132
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.