How much rates vary
Facilitymedian $1,349 · 10th to 90th $200 to $3,890Professionalmedian $182 · 10th to 90th $145 to $295
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 $154.88 Median $218.78 Typical High $794.33 | Facility | None | $154.88 | $218.78 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $331.13 | Professional | None | $154.88 | $199.53 | $331.13 |
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 $141.25 Median $169.82 Typical High $295.12 | Professional | None | $141.25 | $169.82 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $269.15 Typical High $1,202.26 | Facility | None | $141.25 | $269.15 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $275.42 | Professional | None | $165.96 | $223.87 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $851.14 Typical High $1,659.59 | Facility | None | $288.40 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $1,348.96 | Professional | None | $162.18 | $218.78 | $1,348.96 |
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 $151.36 Median $204.17 Typical High $338.84 | Professional | None | $151.36 | $204.17 | $338.84 |
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 $77.62 Median $97.72 Typical High $128.82 | Facility | 52 · Reduced service | $77.62 | $97.72 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $39.81 Typical High $51.29 | Facility | 53 · Discontinued | $30.90 | $39.81 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $147.91 Typical High $194.98 | Facility | 54 · Surgery only | $114.82 | $147.91 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $38.90 | Facility | 55 · Aftercare only | $22.91 | $29.51 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.95 Typical High $25.70 | Facility | 56 · Pre-op care only | $15.49 | $19.95 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $138.04 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $107.15 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $97.72 Typical High $112.20 | Professional | 52 · Reduced service | $77.62 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.90 Typical High $44.67 | Professional | 53 · Discontinued | $30.90 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $147.91 Typical High $165.96 | Professional | 54 · Surgery only | $114.82 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $33.11 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.50 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.49 | $19.50 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $138.04 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $107.15 | $138.04 | $154.88 |
Where Kentucky sits
The same service costs 4.7 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
$186
AK $871KY $186
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.