How much rates vary
Facilitymedian $661 · 10th to 90th $117 to $2,818Professionalmedian $158 · 10th to 90th $107 to $331
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 $117.49 Median $269.15 Typical High $602.56 | Facility | None | $117.49 | $269.15 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $263.03 Typical High $346.74 | Professional | None | $117.49 | $263.03 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $208.93 | Professional | None | $154.88 | $165.96 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $229.09 | Professional | None | $107.15 | $128.82 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $204.17 | Facility | None | $109.65 | $144.54 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $213.80 | Professional | None | $128.82 | $173.78 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $125.89 Typical High $245.47 | Facility | None | $34.67 | $125.89 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $1,819.70 | Professional | None | $131.83 | $288.40 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $53.70 | Professional | None | $33.11 | $33.11 | $53.70 |
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 $128.82 Median $234.42 Typical High $389.05 | Professional | None | $128.82 | $234.42 | $389.05 |
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 $58.88 Median $134.90 Typical High $165.96 | Facility | 52 · Reduced service | $58.88 | $134.90 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $53.70 Typical High $66.07 | Facility | 53 · Discontinued | $23.99 | $53.70 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $199.53 Typical High $251.19 | Facility | 54 · Surgery only | $89.13 | $199.53 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $39.81 Typical High $50.12 | Facility | 55 · Aftercare only | $17.78 | $39.81 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $26.92 Typical High $33.11 | Facility | 56 · Pre-op care only | $11.75 | $26.92 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $186.21 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $83.18 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $58.88 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $52.48 Typical High $66.07 | Professional | 53 · Discontinued | $23.99 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $194.98 Typical High $251.19 | Professional | 54 · Surgery only | $89.13 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $38.90 Typical High $50.12 | Professional | 55 · Aftercare only | $17.78 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $26.30 Typical High $33.11 | Professional | 56 · Pre-op care only | $11.75 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $181.97 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $83.18 | $181.97 | $234.42 |
Where Kentucky sits
The same service costs 3.6 times more in Wisconsin 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
$166
WI $603KY $166
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.