How much rates vary
Facilitymedian $741 · 10th to 90th $123 to $2,818Professionalmedian $120 · 10th to 90th $76 to $224
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 $87.10 Median $194.98 Typical High $478.63 | Facility | None | $87.10 | $194.98 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $173.78 Typical High $281.84 | Professional | None | $87.10 | $173.78 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $154.88 | Professional | None | $72.44 | $97.72 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $151.36 Typical High $323.59 | Facility | None | $81.28 | $151.36 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $158.49 | Professional | None | $85.11 | $134.90 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $204.17 Typical High $269.15 | Facility | None | $34.67 | $204.17 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $1,288.25 | Professional | None | $97.72 | $199.53 | $1,288.25 |
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 $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 $83.18 Median $141.25 Typical High $251.19 | Professional | None | $83.18 | $141.25 | $251.19 |
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 $43.65 Median $72.44 Typical High $112.20 | Facility | 52 · Reduced service | $43.65 | $72.44 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $29.51 Typical High $44.67 | Facility | 53 · Discontinued | $17.78 | $29.51 | $44.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $109.65 Typical High $165.96 | Facility | 54 · Surgery only | $66.07 | $109.65 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $21.88 Typical High $33.11 | Facility | 55 · Aftercare only | $13.18 | $21.88 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.45 Typical High $22.39 | Facility | 56 · Pre-op care only | $8.71 | $14.45 | $22.39 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $102.33 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $61.66 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $72.44 Typical High $112.20 | Professional | 52 · Reduced service | $43.65 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $29.51 Typical High $44.67 | Professional | 53 · Discontinued | $17.78 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $109.65 Typical High $165.96 | Professional | 54 · Surgery only | $66.07 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $21.88 Typical High $33.11 | Professional | 55 · Aftercare only | $13.18 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.45 Typical High $22.39 | Professional | 56 · Pre-op care only | $8.71 | $14.45 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $102.33 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $61.66 | $102.33 | $154.88 |
Where Kentucky sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 51st of 51
$123
AK $501KY $123
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.