How much rates vary
Facilitymedian $1,175 · 10th to 90th $263 to $3,890Professionalmedian $240 · 10th to 90th $186 to $398
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 $208.93 Median $288.40 Typical High $588.84 | Facility | None | $208.93 | $288.40 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $467.74 | Professional | None | $208.93 | $269.15 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | None | $295.12 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $309.03 | Professional | None | $169.82 | $213.80 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $1,202.26 | Facility | None | $223.87 | $363.08 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $380.19 | Professional | None | $204.17 | $309.03 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $851.14 Typical High $1,659.59 | Facility | None | $398.11 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $1,621.81 | Professional | None | $208.93 | $295.12 | $1,621.81 |
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 $199.53 Median $263.03 Typical High $446.68 | Professional | None | $199.53 | $263.03 | $446.68 |
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 $104.71 Median $131.83 Typical High $151.36 | Facility | 52 · Reduced service | $104.71 | $131.83 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $52.48 Typical High $60.26 | Facility | 53 · Discontinued | $41.69 | $52.48 | $60.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $199.53 Typical High $223.87 | Facility | 54 · Surgery only | $158.49 | $199.53 | $223.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $39.81 Typical High $44.67 | Facility | 55 · Aftercare only | $31.62 | $39.81 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.30 Typical High $30.20 | Facility | 56 · Pre-op care only | $20.89 | $26.30 | $30.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $186.21 Typical High $208.93 | Facility | 78 · Unplanned return to OR | $147.91 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $131.83 Typical High $151.36 | Professional | 52 · Reduced service | $104.71 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $52.48 Typical High $60.26 | Professional | 53 · Discontinued | $41.69 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $223.87 | Professional | 54 · Surgery only | $158.49 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $38.90 Typical High $44.67 | Professional | 55 · Aftercare only | $31.62 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.89 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $181.97 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $147.91 | $181.97 | $208.93 |
Where Kentucky sits
The same service costs 4.8 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
$251
AK $1,202KY $251
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.