How much rates vary
Facilitymedian $324 · 10th to 90th $117 to $2,239Professionalmedian $132 · 10th to 90th $91 to $204
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 $102.33 Median $162.18 Typical High $851.14 | Facility | None | $102.33 | $162.18 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $213.80 | Professional | None | $102.33 | $162.18 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $194.98 | Professional | None | $81.28 | $128.82 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $173.78 Typical High $223.87 | Facility | None | $95.50 | $173.78 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $186.21 | Professional | None | $112.20 | $158.49 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $1,318.26 | Facility | None | $151.36 | $190.55 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $954.99 | Professional | None | $107.15 | $181.97 | $954.99 |
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 $100.00 Median $158.49 Typical High $269.15 | Professional | None | $100.00 | $158.49 | $269.15 |
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 $51.29 Median $81.28 Typical High $91.20 | Facility | 52 · Reduced service | $51.29 | $81.28 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $32.36 Typical High $36.31 | Facility | 53 · Discontinued | $20.89 | $32.36 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $120.23 Typical High $138.04 | Facility | 54 · Surgery only | $77.62 | $120.23 | $138.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $27.54 | Facility | 55 · Aftercare only | $15.49 | $23.99 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.22 Typical High $18.20 | Facility | 56 · Pre-op care only | $10.23 | $16.22 | $18.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $112.20 Typical High $128.82 | Facility | 78 · Unplanned return to OR | $72.44 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $79.43 Typical High $91.20 | Professional | 52 · Reduced service | $51.29 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $36.31 | Professional | 53 · Discontinued | $20.89 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $120.23 Typical High $138.04 | Professional | 54 · Surgery only | $77.62 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $27.54 | Professional | 55 · Aftercare only | $15.49 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.85 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.23 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $112.20 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $72.44 | $112.20 | $128.82 |
Where Kentucky sits
The same service costs 3.6 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
$138
AK $501KY $138
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.