How much rates vary
Facilitymedian $1,148 · 10th to 90th $174 to $3,802Professionalmedian $178 · 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 $151.36 Median $213.80 Typical High $794.33 | Facility | None | $151.36 | $213.80 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $338.84 | Professional | None | $151.36 | $190.55 | $338.84 |
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 $173.78 Typical High $295.12 | Professional | None | $141.25 | $173.78 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $186.21 Typical High $263.03 | Facility | None | $141.25 | $186.21 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $269.15 | Professional | None | $165.96 | $229.09 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $275.42 Typical High $1,318.26 | Facility | None | $158.49 | $275.42 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $1,380.38 | Professional | None | $158.49 | $208.93 | $1,380.38 |
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 $151.36 Median $199.53 Typical High $331.13 | Professional | None | $151.36 | $199.53 | $331.13 |
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 $75.86 Median $93.33 Typical High $128.82 | Facility | 52 · Reduced service | $75.86 | $93.33 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $38.02 Typical High $52.48 | Facility | 53 · Discontinued | $30.20 | $38.02 | $52.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $112.20 Median $141.25 Typical High $194.98 | Facility | 54 · Surgery only | $112.20 | $141.25 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $28.18 Typical High $38.90 | Facility | 55 · Aftercare only | $22.91 | $28.18 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.05 Typical High $26.30 | Facility | 56 · Pre-op care only | $15.14 | $19.05 | $26.30 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $131.83 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $104.71 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $75.86 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $30.20 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $141.25 Typical High $158.49 | Professional | 54 · Surgery only | $112.20 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $22.91 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $15.14 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $131.83 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $104.71 | $131.83 | $147.91 |
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
$186
AK $724KY $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.