How much rates vary
Facilitymedian $95 · 10th to 90th $50 to $1,479Professionalmedian $52 · 10th to 90th $34 to $89
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 $45.71 Median $63.10 Typical High $416.87 | Facility | None | $45.71 | $63.10 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $100.00 | Professional | None | $45.71 | $57.54 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $93.33 | Professional | None | $50.12 | $61.66 | $93.33 |
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 $33.11 Median $45.71 Typical High $81.28 | Professional | None | $33.11 | $45.71 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $524.81 Typical High $933.25 | Facility | None | $50.12 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $85.11 | Professional | None | $57.54 | $66.07 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $95.50 | Facility | None | $34.67 | $75.86 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $389.05 | Professional | None | $47.86 | $61.66 | $389.05 |
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 $46.77 Median $66.07 Typical High $102.33 | Professional | None | $46.77 | $66.07 | $102.33 |
13 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 $22.91 Median $28.18 Typical High $36.31 | Facility | 52 · Reduced service | $22.91 | $28.18 | $36.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $11.22 Typical High $14.79 | Facility | 53 · Discontinued | $9.12 | $11.22 | $14.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.88 Median $41.69 Typical High $54.95 | Facility | 54 · Surgery only | $33.88 | $41.69 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $10.96 | Facility | 55 · Aftercare only | $6.92 | $8.32 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.62 Typical High $7.41 | Facility | 56 · Pre-op care only | $4.57 | $5.62 | $7.41 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $38.90 Typical High $51.29 | Facility | 78 · Unplanned return to OR | $31.62 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $28.18 Typical High $31.62 | Professional | 52 · Reduced service | $22.91 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $11.22 Typical High $12.59 | Professional | 53 · Discontinued | $9.12 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $41.69 Typical High $46.77 | Professional | 54 · Surgery only | $33.88 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $9.55 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.62 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.57 | $5.62 | $6.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $38.90 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $31.62 | $38.90 | $43.65 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $52.48 Median $61.66 Typical High $93.33 | Professional | 59 · Distinct service | $52.48 | $61.66 | $93.33 |
Where Kentucky sits
The same service costs 4.2 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
$53.70
AK $224KY $53.70
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.