How much rates vary
Facilitymedian $1,413 · 10th to 90th $275 to $3,890Professionalmedian $263 · 10th to 90th $191 to $380
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 $199.53 Median $275.42 Typical High $851.14 | Facility | None | $199.53 | $275.42 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $407.38 | Professional | None | $199.53 | $275.42 | $407.38 |
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 $190.55 Median $251.19 Typical High $363.08 | Professional | None | $190.55 | $251.19 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $1,202.26 | Facility | None | $213.80 | $346.74 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $363.08 | Professional | None | $218.78 | $302.00 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $851.14 Typical High $1,659.59 | Facility | None | $354.81 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $1,659.59 | Professional | None | $208.93 | $309.03 | $1,659.59 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $489.78 | Professional | None | $204.17 | $281.84 | $489.78 |
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 $100.00 Median $138.04 Typical High $158.49 | Facility | 52 · Reduced service | $100.00 | $138.04 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $63.10 | Facility | 53 · Discontinued | $39.81 | $54.95 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $208.93 Typical High $239.88 | Facility | 54 · Surgery only | $151.36 | $208.93 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $41.69 Typical High $47.86 | Facility | 55 · Aftercare only | $30.20 | $41.69 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $31.62 | Facility | 56 · Pre-op care only | $19.95 | $27.54 | $31.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $194.98 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $141.25 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $100.00 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $151.36 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $30.20 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.95 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $190.55 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $141.25 | $190.55 | $218.78 |
Where Kentucky sits
The same service costs 4.0 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
$269
AK $1,072KY $269
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.