How much rates vary
Facilitymedian $741 · 10th to 90th $65 to $2,818Professionalmedian $74 · 10th to 90th $43 to $135
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 $57.54 Median $91.20 Typical High $416.87 | Facility | None | $57.54 | $91.20 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $154.88 | Professional | None | $57.54 | $91.20 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $151.36 | Professional | None | $72.44 | $102.33 | $151.36 |
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 $38.90 Median $63.10 Typical High $89.13 | Professional | None | $38.90 | $63.10 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $524.81 Typical High $933.25 | Facility | None | $61.66 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $138.04 | Professional | None | $74.13 | $100.00 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $107.15 | Facility | None | $34.67 | $75.86 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $102.33 Typical High $537.03 | Professional | None | $58.88 | $102.33 | $537.03 |
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 $54.95 Median $87.10 Typical High $147.91 | Professional | None | $54.95 | $87.10 | $147.91 |
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 $28.84 Median $38.02 Typical High $51.29 | Facility | 52 · Reduced service | $28.84 | $38.02 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $15.14 Typical High $20.89 | Facility | 53 · Discontinued | $11.48 | $15.14 | $20.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $42.66 Median $57.54 Typical High $77.62 | Facility | 54 · Surgery only | $42.66 | $57.54 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $11.48 Typical High $15.49 | Facility | 55 · Aftercare only | $8.51 | $11.48 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.59 Typical High $10.23 | Facility | 56 · Pre-op care only | $5.75 | $7.59 | $10.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $39.81 Median $53.70 Typical High $72.44 | Facility | 78 · Unplanned return to OR | $39.81 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $28.84 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $11.48 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $66.07 Typical High $77.62 | Professional | 54 · Surgery only | $42.66 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $8.51 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.71 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.75 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $39.81 Median $61.66 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $39.81 | $61.66 | $72.44 |
Where Kentucky sits
The same service costs 3.9 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
$79.43
AK $309KY $79.43
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.