How much rates vary
Facilitymedian $525 · 10th to 90th $145 to $2,754Professionalmedian $170 · 10th to 90th $115 to $309
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 $131.83 Median $213.80 Typical High $794.33 | Facility | None | $131.83 | $213.80 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $269.15 | Professional | None | $131.83 | $208.93 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $186.21 | Professional | None | $112.20 | $138.04 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $1,202.26 | Facility | None | $141.25 | $229.09 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $234.42 | Professional | None | $141.25 | $190.55 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $398.11 Typical High $912.01 | Facility | None | $34.67 | $398.11 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $1,318.26 | Professional | None | $147.91 | $245.47 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $74.13 | Professional | None | $33.11 | $33.11 | $74.13 |
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 $151.36 Median $234.42 Typical High $354.81 | Professional | None | $151.36 | $234.42 | $354.81 |
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 $66.07 Median $97.72 Typical High $134.90 | Facility | 52 · Reduced service | $66.07 | $97.72 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $38.90 Typical High $53.70 | Facility | 53 · Discontinued | $26.30 | $38.90 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $199.53 | Facility | 54 · Surgery only | $97.72 | $144.54 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $39.81 | Facility | 55 · Aftercare only | $19.50 | $28.84 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.50 Typical High $26.92 | Facility | 56 · Pre-op care only | $13.18 | $19.50 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $91.20 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $97.72 Typical High $134.90 | Professional | 52 · Reduced service | $66.07 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $39.81 Typical High $53.70 | Professional | 53 · Discontinued | $26.30 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $147.91 Typical High $199.53 | Professional | 54 · Surgery only | $97.72 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $29.51 Typical High $39.81 | Professional | 55 · Aftercare only | $19.50 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.50 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.18 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $138.04 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $91.20 | $138.04 | $186.21 |
Where Kentucky sits
The same service costs 4.5 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
$170
AK $759KY $170
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.