How much rates vary
Facilitymedian $129 · 10th to 90th $74 to $1,862Professionalmedian $107 · 10th to 90th $72 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 $74.13 Median $120.23 Typical High $851.14 | Facility | None | $74.13 | $120.23 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $181.97 | Professional | None | $74.13 | $120.23 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $186.21 Typical High $186.21 | Professional | None | $53.70 | $186.21 | $186.21 |
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 $64.57 Median $95.50 Typical High $141.25 | Professional | None | $64.57 | $95.50 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $524.81 Typical High $933.25 | Facility | None | $79.43 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $181.97 | Professional | None | $95.50 | $131.83 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $128.82 | Facility | None | $34.67 | $75.86 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $691.83 | Professional | None | $81.28 | $134.90 | $691.83 |
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 $79.43 Median $120.23 Typical High $194.98 | Professional | None | $79.43 | $120.23 | $194.98 |
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 $37.15 Median $57.54 Typical High $69.18 | Facility | 52 · Reduced service | $37.15 | $57.54 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $22.91 Typical High $27.54 | Facility | 53 · Discontinued | $14.79 | $22.91 | $27.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $54.95 Median $87.10 Typical High $102.33 | Facility | 54 · Surgery only | $54.95 | $87.10 | $102.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $17.38 Typical High $20.42 | Facility | 55 · Aftercare only | $11.22 | $17.38 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.48 Typical High $13.80 | Facility | 56 · Pre-op care only | $7.41 | $11.48 | $13.80 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $81.28 Typical High $95.50 | Facility | 78 · Unplanned return to OR | $51.29 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $37.15 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $14.79 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $54.95 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $11.22 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $7.41 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $81.28 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $51.29 | $81.28 | $95.50 |
Where Kentucky sits
The same service costs 3.5 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
$110
AK $389KY $110
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.