How much rates vary
Facilitymedian $813 · 10th to 90th $85 to $2,818Professionalmedian $87 · 10th to 90th $58 to $166
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 $75.86 Median $131.83 Typical High $794.33 | Facility | None | $75.86 | $131.83 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $199.53 | Professional | None | $75.86 | $131.83 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $131.83 | Professional | None | $51.29 | $75.86 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $524.81 Typical High $933.25 | Facility | None | $85.11 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $141.25 | Professional | None | $75.86 | $114.82 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $154.88 | Facility | None | $34.67 | $75.86 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $151.36 Typical High $794.33 | Professional | None | $79.43 | $151.36 | $794.33 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $58.88 Median $107.15 Typical High $204.17 | Professional | None | $58.88 | $107.15 | $204.17 |
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 $38.02 Median $44.67 Typical High $75.86 | Facility | 52 · Reduced service | $38.02 | $44.67 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $17.78 Typical High $30.20 | Facility | 53 · Discontinued | $15.14 | $17.78 | $30.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $66.07 Typical High $112.20 | Facility | 54 · Surgery only | $57.54 | $66.07 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $13.18 Typical High $22.39 | Facility | 55 · Aftercare only | $11.48 | $13.18 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.91 Typical High $15.14 | Facility | 56 · Pre-op care only | $7.59 | $8.91 | $15.14 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $61.66 Typical High $104.71 | Facility | 78 · Unplanned return to OR | $53.70 | $61.66 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $58.88 Typical High $75.86 | Professional | 52 · Reduced service | $38.02 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $23.99 Typical High $30.20 | Professional | 53 · Discontinued | $15.14 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $89.13 Typical High $112.20 | Professional | 54 · Surgery only | $57.54 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.78 Typical High $22.39 | Professional | 55 · Aftercare only | $11.48 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.75 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.59 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $83.18 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $53.70 | $83.18 | $104.71 |
Where Kentucky sits
The same service costs 4.5 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
$91.20
AK $407KY $91.20
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.