How much rates vary
Facilitymedian $1,072 · 10th to 90th $186 to $2,818Professionalmedian $166 · 10th to 90th $129 to $263
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 $138.04 Median $208.93 Typical High $416.87 | Facility | None | $138.04 | $208.93 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $316.23 | Professional | None | $138.04 | $186.21 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $263.03 | Professional | None | $125.89 | $154.88 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $1,202.26 | Facility | None | $147.91 | $239.88 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $251.19 | Professional | None | $151.36 | $213.80 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $851.14 Typical High $1,318.26 | Facility | None | $263.03 | $851.14 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $1,230.27 | Professional | None | $147.91 | $208.93 | $1,230.27 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $316.23 | Professional | None | $134.90 | $181.97 | $316.23 |
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 $69.18 Median $93.33 Typical High $114.82 | Facility | 52 · Reduced service | $69.18 | $93.33 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $37.15 Typical High $45.71 | Facility | 53 · Discontinued | $28.18 | $37.15 | $45.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $138.04 Typical High $173.78 | Facility | 54 · Surgery only | $104.71 | $138.04 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $27.54 Typical High $34.67 | Facility | 55 · Aftercare only | $20.89 | $27.54 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.62 Typical High $22.91 | Facility | 56 · Pre-op care only | $13.80 | $18.62 | $22.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $128.82 Typical High $162.18 | Facility | 78 · Unplanned return to OR | $97.72 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $69.18 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $28.18 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $104.71 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $20.89 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.80 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $97.72 | $128.82 | $147.91 |
Where Kentucky sits
The same service costs 4.6 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
$174
AK $794KY $174
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.