How much rates vary
Facilitymedian $162 · 10th to 90th $87 to $1,778Professionalmedian $129 · 10th to 90th $93 to $204
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 $93.33 Median $144.54 Typical High $794.33 | Facility | None | $93.33 | $144.54 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $218.78 | Professional | None | $93.33 | $144.54 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $208.93 | Professional | None | $128.82 | $162.18 | $208.93 |
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 $87.10 Median $117.49 Typical High $177.83 | Professional | None | $87.10 | $117.49 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $524.81 Typical High $933.25 | Facility | None | $100.00 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $223.87 | Professional | None | $123.03 | $158.49 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $162.18 | Facility | None | $34.67 | $75.86 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $831.76 | Professional | None | $102.33 | $162.18 | $831.76 |
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 $100.00 Median $144.54 Typical High $239.88 | Professional | None | $100.00 | $144.54 | $239.88 |
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 $46.77 Median $72.44 Typical High $83.18 | Facility | 52 · Reduced service | $46.77 | $72.44 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $28.84 Typical High $33.11 | Facility | 53 · Discontinued | $18.62 | $28.84 | $33.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $107.15 Typical High $123.03 | Facility | 54 · Surgery only | $69.18 | $107.15 | $123.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $21.38 Typical High $24.55 | Facility | 55 · Aftercare only | $14.13 | $21.38 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $14.45 Typical High $16.60 | Facility | 56 · Pre-op care only | $9.33 | $14.45 | $16.60 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $100.00 Typical High $114.82 | Facility | 78 · Unplanned return to OR | $64.57 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $72.44 Typical High $83.18 | Professional | 52 · Reduced service | $46.77 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $28.84 Typical High $33.11 | Professional | 53 · Discontinued | $18.62 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $107.15 Typical High $123.03 | Professional | 54 · Surgery only | $69.18 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $14.13 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $14.45 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.33 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $100.00 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $64.57 | $100.00 | $114.82 |
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
$132
AK $447KY $132
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.