How much rates vary
Facilitymedian $832 · 10th to 90th $135 to $2,818Professionalmedian $129 · 10th to 90th $93 to $204
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 $97.72 Median $158.49 Typical High $416.87 | Facility | None | $97.72 | $158.49 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $245.47 | Professional | None | $97.72 | $141.25 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $204.17 | Professional | None | $75.86 | $125.89 | $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 $89.13 Median $114.82 Typical High $204.17 | Professional | None | $89.13 | $114.82 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $190.55 | Facility | None | $104.71 | $147.91 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $213.80 | Professional | None | $125.89 | $151.36 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $177.83 Typical High $1,318.26 | Facility | None | $128.82 | $177.83 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $977.24 | Professional | None | $107.15 | $158.49 | $977.24 |
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 $95.50 Median $138.04 Typical High $234.42 | Professional | None | $95.50 | $138.04 | $234.42 |
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 $48.98 Median $70.79 Typical High $93.33 | Facility | 52 · Reduced service | $48.98 | $70.79 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $28.18 Typical High $37.15 | Facility | 53 · Discontinued | $19.50 | $28.18 | $37.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $72.44 Median $104.71 Typical High $138.04 | Facility | 54 · Surgery only | $72.44 | $104.71 | $138.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $20.89 Typical High $27.54 | Facility | 55 · Aftercare only | $14.45 | $20.89 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.13 Typical High $18.62 | Facility | 56 · Pre-op care only | $9.77 | $14.13 | $18.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $97.72 Typical High $128.82 | Facility | 78 · Unplanned return to OR | $67.61 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $48.98 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $19.50 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $104.71 Typical High $117.49 | Professional | 54 · Surgery only | $72.44 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $14.45 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.77 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $97.72 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $67.61 | $97.72 | $112.20 |
Where Kentucky sits
The same service costs 3.8 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
$138
AK $525KY $138
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.