How much rates vary
Facilitymedian $126 · 10th to 90th $81 to $1,778Professionalmedian $107 · 10th to 90th $78 to $158
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 $81.28 Median $123.03 Typical High $851.14 | Facility | None | $81.28 | $123.03 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $165.96 | Professional | None | $81.28 | $123.03 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $72.44 Median $102.33 Typical High $151.36 | Professional | None | $72.44 | $102.33 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $162.18 | Facility | None | $87.10 | $128.82 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $144.54 | Professional | None | $79.43 | $123.03 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $112.20 Typical High $141.25 | Facility | None | $34.67 | $112.20 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $707.95 | Professional | None | $89.13 | $138.04 | $707.95 |
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 $85.11 Median $125.89 Typical High $199.53 | Professional | None | $85.11 | $125.89 | $199.53 |
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 $40.74 Median $61.66 Typical High $69.18 | Facility | 52 · Reduced service | $40.74 | $61.66 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $24.55 Typical High $27.54 | Facility | 53 · Discontinued | $16.22 | $24.55 | $27.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $93.33 Typical High $104.71 | Facility | 54 · Surgery only | $61.66 | $93.33 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $18.62 Typical High $20.89 | Facility | 55 · Aftercare only | $12.30 | $18.62 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.30 Typical High $13.80 | Facility | 56 · Pre-op care only | $8.13 | $12.30 | $13.80 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $87.10 Typical High $97.72 | Facility | 78 · Unplanned return to OR | $57.54 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $40.74 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $23.99 Typical High $27.54 | Professional | 53 · Discontinued | $16.22 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $61.66 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $12.30 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.13 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $85.11 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $57.54 | $85.11 | $97.72 |
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.