How much rates vary
Facilitymedian $1,072 · 10th to 90th $186 to $3,802Professionalmedian $195 · 10th to 90th $135 to $288
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 $141.25 Median $229.09 Typical High $794.33 | Facility | None | $141.25 | $229.09 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $316.23 | Professional | None | $141.25 | $208.93 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $275.42 | Professional | None | $134.90 | $177.83 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $208.93 Typical High $269.15 | Facility | None | $151.36 | $208.93 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $257.04 | Professional | None | $151.36 | $208.93 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $251.19 Typical High $1,318.26 | Facility | None | $177.83 | $251.19 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $1,202.26 | Professional | None | $147.91 | $234.42 | $1,202.26 |
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 $147.91 Median $213.80 Typical High $346.74 | Professional | None | $147.91 | $213.80 | $346.74 |
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 $70.79 Median $104.71 Typical High $117.49 | Facility | 52 · Reduced service | $70.79 | $104.71 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $46.77 | Facility | 53 · Discontinued | $28.18 | $41.69 | $46.77 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $173.78 | Facility | 54 · Surgery only | $107.15 | $154.88 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $35.48 | Facility | 55 · Aftercare only | $21.38 | $30.90 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $23.44 | Facility | 56 · Pre-op care only | $14.13 | $20.89 | $23.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $162.18 | Facility | 78 · Unplanned return to OR | $100.00 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $70.79 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $28.18 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $173.78 | Professional | 54 · Surgery only | $107.15 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $162.18 |
Where Kentucky sits
The same service costs 3.4 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
$204
AK $692KY $204
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.