How much rates vary
Facilitymedian $115 · 10th to 90th $71 to $1,380Professionalmedian $87 · 10th to 90th $72 to $141
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 $81.28 Median $83.18 Typical High $100.00 | Facility | None | $81.28 | $83.18 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $120.23 | Professional | None | $81.28 | $95.50 | $120.23 |
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 $63.10 Median $74.13 Typical High $97.72 | Professional | None | $63.10 | $74.13 | $97.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $112.20 Typical High $144.54 | Professional | 50 · Both sides | $93.33 | $112.20 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $524.81 Typical High $933.25 | Facility | None | $70.79 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $117.49 | Professional | None | $70.79 | $97.72 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $123.03 | Facility | None | $34.67 | $75.86 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $457.09 | Professional | None | $72.44 | $102.33 | $457.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $87.10 Median $107.15 Typical High $151.36 | Professional | None | $87.10 | $107.15 | $151.36 |
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 $39.81 Median $41.69 Typical High $50.12 | Facility | 52 · Reduced service | $39.81 | $41.69 | $50.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $16.98 Typical High $19.95 | Facility | 53 · Discontinued | $16.22 | $16.98 | $19.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $63.10 Typical High $74.13 | Facility | 54 · Surgery only | $60.26 | $63.10 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $15.14 | Facility | 55 · Aftercare only | $12.02 | $12.59 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $10.00 | Facility | 56 · Pre-op care only | $7.94 | $8.32 | $10.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $58.88 Typical High $69.18 | Facility | 78 · Unplanned return to OR | $56.23 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $45.71 Typical High $50.12 | Professional | 52 · Reduced service | $39.81 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $18.62 Typical High $19.95 | Professional | 53 · Discontinued | $16.22 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $69.18 Typical High $74.13 | Professional | 54 · Surgery only | $60.26 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.80 Typical High $15.14 | Professional | 55 · Aftercare only | $12.02 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.33 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.94 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $64.57 Typical High $69.18 | Professional | 78 · Unplanned return to OR | $56.23 | $64.57 | $69.18 |
Where Kentucky sits
The same service costs 4.2 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· 50th of 51
$89.13
AK $324FL $77.62
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.