How much rates vary
Facilitymedian $151 · 10th to 90th $89 to $1,778Professionalmedian $115 · 10th to 90th $83 to $200
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 $120.23 Median $144.54 Typical High $851.14 | Facility | None | $120.23 | $144.54 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $194.98 | Professional | None | $114.82 | $144.54 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $134.90 | Professional | None | $67.61 | $131.83 | $134.90 |
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 $83.18 Median $97.72 Typical High $120.23 | Professional | None | $83.18 | $97.72 | $120.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $144.54 Typical High $177.83 | Professional | 50 · Both sides | $125.89 | $144.54 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $123.03 Typical High $165.96 | Facility | None | $104.71 | $123.03 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $177.83 | Professional | None | $128.82 | $141.25 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $109.65 Typical High $177.83 | Facility | None | $34.67 | $109.65 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $1,023.29 | Professional | None | $107.15 | $131.83 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.90 | Professional | None | $33.11 | $33.11 | $38.90 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $208.93 | Professional | None | $102.33 | $125.89 | $208.93 |
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 $60.26 Median $72.44 Typical High $95.50 | Facility | 52 · Reduced service | $60.26 | $72.44 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $28.84 Typical High $38.02 | Facility | 53 · Discontinued | $23.99 | $28.84 | $38.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $109.65 Typical High $141.25 | Facility | 54 · Surgery only | $89.13 | $109.65 | $141.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $21.88 Typical High $28.84 | Facility | 55 · Aftercare only | $17.78 | $21.88 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.45 Typical High $19.05 | Facility | 56 · Pre-op care only | $12.02 | $14.45 | $19.05 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $102.33 Typical High $131.83 | Facility | 78 · Unplanned return to OR | $83.18 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $70.79 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $28.18 Typical High $30.20 | Professional | 53 · Discontinued | $23.99 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $107.15 Typical High $114.82 | Professional | 54 · Surgery only | $89.13 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $21.38 Typical High $22.91 | Professional | 55 · Aftercare only | $17.78 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.13 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.02 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $100.00 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $83.18 | $100.00 | $107.15 |
Where Kentucky sits
The same service costs 4.1 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· 49th of 51
$120
AK $468FL $115
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.