How much rates vary
Facilitymedian $1,122 · 10th to 90th $240 to $2,818Professionalmedian $174 · 10th to 90th $123 to $447
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 $123.03 Median $281.84 Typical High $851.14 | Facility | None | $123.03 | $281.84 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $281.84 Typical High $371.54 | Professional | None | $123.03 | $281.84 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $245.47 | Professional | None | $120.23 | $144.54 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $1,202.26 | Facility | None | $131.83 | $213.80 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $213.80 | Professional | None | $131.83 | $173.78 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $851.14 Typical High $1,318.26 | Facility | None | $239.88 | $851.14 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $316.23 Typical High $1,778.28 | Professional | None | $134.90 | $316.23 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $61.66 | Professional | None | $33.11 | $33.11 | $61.66 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $147.91 Median $309.03 Typical High $602.56 | Professional | None | $147.91 | $309.03 | $602.56 |
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 $61.66 Median $141.25 Typical High $173.78 | Facility | 52 · Reduced service | $61.66 | $141.25 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $56.23 Typical High $69.18 | Facility | 53 · Discontinued | $24.55 | $56.23 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $208.93 Typical High $263.03 | Facility | 54 · Surgery only | $91.20 | $208.93 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $41.69 Typical High $52.48 | Facility | 55 · Aftercare only | $18.20 | $41.69 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $28.18 Typical High $34.67 | Facility | 56 · Pre-op care only | $12.30 | $28.18 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $194.98 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $85.11 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $138.04 Typical High $173.78 | Professional | 52 · Reduced service | $61.66 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $54.95 Typical High $69.18 | Professional | 53 · Discontinued | $24.55 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $91.20 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $18.20 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $27.54 Typical High $34.67 | Professional | 56 · Pre-op care only | $12.30 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $85.11 | $190.55 | $245.47 |
Where Kentucky sits
The same service costs 4.0 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
$191
AK $759KY $191
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.