How much rates vary
Facilitymedian $1,072 · 10th to 90th $234 to $2,818Professionalmedian $224 · 10th to 90th $186 to $363
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 $190.55 Median $234.42 Typical High $851.14 | Facility | None | $190.55 | $234.42 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $331.13 | Professional | None | $190.55 | $234.42 | $331.13 |
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 $181.97 Median $218.78 Typical High $363.08 | Professional | None | $181.97 | $218.78 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $331.13 Typical High $1,202.26 | Facility | None | $177.83 | $331.13 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $346.74 | Professional | None | $186.21 | $295.12 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $851.14 Typical High $1,318.26 | Facility | None | $346.74 | $851.14 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $1,737.80 | Professional | None | $204.17 | $263.03 | $1,737.80 |
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 $194.98 Median $251.19 Typical High $416.87 | Professional | None | $194.98 | $251.19 | $416.87 |
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 $95.50 Median $117.49 Typical High $162.18 | Facility | 52 · Reduced service | $95.50 | $117.49 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $64.57 | Facility | 53 · Discontinued | $38.02 | $46.77 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $245.47 | Facility | 54 · Surgery only | $144.54 | $177.83 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $48.98 | Facility | 55 · Aftercare only | $28.84 | $35.48 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $32.36 | Facility | 56 · Pre-op care only | $19.05 | $23.44 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $165.96 Typical High $229.09 | Facility | 78 · Unplanned return to OR | $134.90 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $117.49 Typical High $131.83 | Professional | 52 · Reduced service | $95.50 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $53.70 | Professional | 53 · Discontinued | $38.02 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $199.53 | Professional | 54 · Surgery only | $144.54 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $28.84 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $165.96 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $134.90 | $165.96 | $186.21 |
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
$234
AK $912KY $234
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.