How much rates vary
Facilitymedian $562 · 10th to 90th $100 to $2,818Professionalmedian $107 · 10th to 90th $78 to $178
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 $89.13 Median $131.83 Typical High $398.11 | Facility | None | $89.13 | $131.83 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $218.78 | Professional | None | $89.13 | $123.03 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $204.17 | Professional | None | $95.50 | $102.33 | $204.17 |
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 $69.18 Median $102.33 Typical High $144.54 | Professional | None | $69.18 | $102.33 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $134.90 Typical High $173.78 | Facility | None | $95.50 | $134.90 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $186.21 | Professional | None | $114.82 | $134.90 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $131.83 Typical High $173.78 | Facility | None | $34.67 | $131.83 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $758.58 | Professional | None | $97.72 | $138.04 | $758.58 |
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 $81.28 Median $120.23 Typical High $204.17 | Professional | None | $81.28 | $120.23 | $204.17 |
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 $60.26 Typical High $69.18 | Facility | 52 · Reduced service | $43.65 | $60.26 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $24.55 Typical High $28.18 | Facility | 53 · Discontinued | $17.78 | $24.55 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $91.20 Typical High $104.71 | Facility | 54 · Surgery only | $66.07 | $91.20 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $18.20 Typical High $20.89 | Facility | 55 · Aftercare only | $13.18 | $18.20 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.30 Typical High $13.80 | Facility | 56 · Pre-op care only | $8.71 | $12.30 | $13.80 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $85.11 Typical High $97.72 | Facility | 78 · Unplanned return to OR | $61.66 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $43.65 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $17.78 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $89.13 Typical High $104.71 | Professional | 54 · Surgery only | $66.07 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $13.18 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.71 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $83.18 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $61.66 | $83.18 | $97.72 |
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
$110
AK $447KY $110
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.