How much rates vary
Facilitymedian $1,318 · 10th to 90th $155 to $8,128Professionalmedian $148 · 10th to 90th $115 to $234
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 $123.03 Median $177.83 Typical High $794.33 | Facility | None | $123.03 | $177.83 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $275.42 | Professional | None | $123.03 | $165.96 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $177.83 | Professional | None | $85.11 | $85.11 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $234.42 | Professional | None | $112.20 | $141.25 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $213.80 | Facility | None | $131.83 | $165.96 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $239.88 | Professional | None | $162.18 | $186.21 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $1,318.26 | Facility | None | $141.25 | $229.09 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $1,122.02 | Professional | None | $128.82 | $177.83 | $1,122.02 |
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 $123.03 Median $162.18 Typical High $275.42 | Professional | None | $123.03 | $162.18 | $275.42 |
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 $61.66 Median $79.43 Typical High $104.71 | Facility | 52 · Reduced service | $61.66 | $79.43 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $31.62 Typical High $41.69 | Facility | 53 · Discontinued | $24.55 | $31.62 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $117.49 Typical High $158.49 | Facility | 54 · Surgery only | $93.33 | $117.49 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $31.62 | Facility | 55 · Aftercare only | $18.62 | $23.99 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.85 Typical High $20.89 | Facility | 56 · Pre-op care only | $12.30 | $15.85 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $109.65 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $87.10 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $61.66 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $24.55 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $93.33 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.30 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $109.65 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $87.10 | $109.65 | $125.89 |
Where Kentucky sits
The same service costs 3.9 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
$155
AK $603KY $155
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.