How much rates vary
Facilitymedian $339 · 10th to 90th $174 to $1,995Professionalmedian $224 · 10th to 90th $178 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 $173.78 Median $204.17 Typical High $302.00 | Facility | None | $173.78 | $204.17 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $338.84 | Professional | None | $173.78 | $269.15 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $346.74 | Professional | None | $177.83 | $213.80 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $524.81 Typical High $933.25 | Facility | None | $190.55 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $309.03 | Professional | None | $190.55 | $263.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $281.84 Typical High $512.86 | Facility | None | $34.67 | $281.84 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $1,584.89 | Professional | None | $194.98 | $302.00 | $1,584.89 |
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 $218.78 Median $331.13 Typical High $512.86 | Professional | None | $218.78 | $331.13 | $512.86 |
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 $87.10 Median $102.33 Typical High $151.36 | Facility | 52 · Reduced service | $87.10 | $102.33 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $40.74 Typical High $60.26 | Facility | 53 · Discontinued | $34.67 | $40.74 | $60.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $154.88 Typical High $229.09 | Facility | 54 · Surgery only | $131.83 | $154.88 | $229.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $30.90 Typical High $45.71 | Facility | 55 · Aftercare only | $26.30 | $30.90 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.42 Typical High $30.20 | Facility | 56 · Pre-op care only | $17.38 | $20.42 | $30.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $144.54 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $123.03 | $144.54 | $213.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $134.90 Typical High $151.36 | Professional | 52 · Reduced service | $87.10 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $53.70 Typical High $60.26 | Professional | 53 · Discontinued | $34.67 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $199.53 Typical High $229.09 | Professional | 54 · Surgery only | $131.83 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $39.81 Typical High $45.71 | Professional | 55 · Aftercare only | $26.30 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.92 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $186.21 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $123.03 | $186.21 | $213.80 |
Where Kentucky sits
The same service costs 4.1 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
$229
AK $933KY $229
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.