How much rates vary
Facilitymedian $302 · 10th to 90th $141 to $2,239Professionalmedian $178 · 10th to 90th $132 to $302
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 $208.93 Typical High $851.14 | Facility | None | $131.83 | $208.93 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $257.04 | Professional | None | $131.83 | $204.17 | $257.04 |
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 $131.83 Median $154.88 Typical High $213.80 | Professional | None | $131.83 | $154.88 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $234.42 Typical High $323.59 | Professional | 50 · Both sides | $186.21 | $234.42 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $288.40 | Facility | None | $141.25 | $229.09 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $239.88 | Professional | None | $158.49 | $194.98 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $218.78 Typical High $398.11 | Facility | None | $34.67 | $218.78 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $1,258.93 | Professional | None | $147.91 | $234.42 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $83.18 | Professional | None | $33.11 | $33.11 | $83.18 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $346.74 | Professional | None | $154.88 | $229.09 | $346.74 |
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 $100.00 Typical High $128.82 | Facility | 52 · Reduced service | $66.07 | $100.00 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $39.81 Typical High $51.29 | Facility | 53 · Discontinued | $26.30 | $39.81 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $147.91 Typical High $190.55 | Facility | 54 · Surgery only | $100.00 | $147.91 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $29.51 Typical High $38.90 | Facility | 55 · Aftercare only | $19.95 | $29.51 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.95 Typical High $25.70 | Facility | 56 · Pre-op care only | $13.18 | $19.95 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $138.04 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $93.33 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $100.00 Typical High $128.82 | Professional | 52 · Reduced service | $66.07 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $39.81 Typical High $51.29 | Professional | 53 · Discontinued | $26.30 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $100.00 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.20 Typical High $38.90 | Professional | 55 · Aftercare only | $19.95 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.95 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.18 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $141.25 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $93.33 | $141.25 | $177.83 |
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
$182
AK $646KY $182
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.