How much rates vary
Facilitymedian $117 · 10th to 90th $66 to $1,778Professionalmedian $87 · 10th to 90th $60 to $151
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 $66.07 Median $95.50 Typical High $794.33 | Facility | None | $66.07 | $95.50 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $141.25 | Professional | None | $66.07 | $95.50 | $141.25 |
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 $57.54 Median $67.61 Typical High $100.00 | Professional | None | $57.54 | $67.61 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $102.33 Typical High $151.36 | Professional | 50 · Both sides | $87.10 | $102.33 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $107.15 Typical High $134.90 | Facility | None | $60.26 | $107.15 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $117.49 | Professional | None | $79.43 | $97.72 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $104.71 Typical High $398.11 | Facility | None | $34.67 | $104.71 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $602.56 | Professional | None | $74.13 | $107.15 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $60.26 | Professional | None | $33.11 | $33.11 | $60.26 |
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 $79.43 Median $104.71 Typical High $169.82 | Professional | None | $79.43 | $104.71 | $169.82 |
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 $33.11 Median $44.67 Typical High $60.26 | Facility | 52 · Reduced service | $33.11 | $44.67 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $17.78 Typical High $23.99 | Facility | 53 · Discontinued | $13.18 | $17.78 | $23.99 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $48.98 Median $66.07 Typical High $89.13 | Facility | 54 · Surgery only | $48.98 | $66.07 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $13.18 Typical High $17.78 | Facility | 55 · Aftercare only | $9.77 | $13.18 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.91 Typical High $12.02 | Facility | 56 · Pre-op care only | $6.61 | $8.91 | $12.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $61.66 Typical High $83.18 | Facility | 78 · Unplanned return to OR | $45.71 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $46.77 Typical High $60.26 | Professional | 52 · Reduced service | $33.11 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.05 Typical High $23.99 | Professional | 53 · Discontinued | $13.18 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $70.79 Typical High $89.13 | Professional | 54 · Surgery only | $48.98 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.13 Typical High $17.78 | Professional | 55 · Aftercare only | $9.77 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.33 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.61 | $9.33 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $66.07 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $45.71 | $66.07 | $83.18 |
Where Kentucky sits
The same service costs 3.7 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
$87.10
AK $324KY $87.10
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.