How much rates vary
Facilitymedian $1,000 · 10th to 90th $182 to $3,802Professionalmedian $257 · 10th to 90th $170 to $398
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 $181.97 Median $309.03 Typical High $851.14 | Facility | None | $181.97 | $309.03 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $436.52 | Professional | None | $181.97 | $309.03 | $436.52 |
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 $154.88 Median $223.87 Typical High $331.13 | Professional | None | $154.88 | $223.87 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $549.54 | Facility | None | $194.98 | $316.23 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $323.59 | Professional | None | $199.53 | $275.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $1,659.59 | Facility | None | $331.13 | $467.74 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $1,862.09 | Professional | None | $199.53 | $346.74 | $1,862.09 |
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 $181.97 Median $281.84 Typical High $501.19 | Professional | None | $181.97 | $281.84 | $501.19 |
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 $91.20 Median $141.25 Typical High $177.83 | Facility | 52 · Reduced service | $91.20 | $141.25 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $57.54 Typical High $70.79 | Facility | 53 · Discontinued | $36.31 | $57.54 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $134.90 Median $213.80 Typical High $263.03 | Facility | 54 · Surgery only | $134.90 | $213.80 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $52.48 | Facility | 55 · Aftercare only | $27.54 | $42.66 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.18 Typical High $35.48 | Facility | 56 · Pre-op care only | $18.20 | $28.18 | $35.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $199.53 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $125.89 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $91.20 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $57.54 Typical High $70.79 | Professional | 53 · Discontinued | $36.31 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $213.80 Typical High $263.03 | Professional | 54 · Surgery only | $134.90 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.18 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.20 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $199.53 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $125.89 | $199.53 | $245.47 |
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
$257
AK $871KY $257
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.