How much rates vary
Facilitymedian $1,072 · 10th to 90th $178 to $3,802Professionalmedian $158 · 10th to 90th $91 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 $112.20 Median $194.98 Typical High $851.14 | Facility | None | $112.20 | $194.98 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $269.15 | Professional | None | $112.20 | $186.21 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $239.88 | Professional | None | $89.13 | $109.65 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $165.96 Typical High $363.08 | Professional | 50 · Both sides | $131.83 | $165.96 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $194.98 Typical High $269.15 | Facility | None | $104.71 | $194.98 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $199.53 | Professional | None | $134.90 | $165.96 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $194.98 Typical High $398.11 | Facility | None | $34.67 | $194.98 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $1,949.84 | Professional | None | $125.89 | $218.78 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $66.07 | Professional | None | $33.11 | $33.11 | $66.07 |
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 $134.90 Median $213.80 Typical High $338.84 | Professional | None | $134.90 | $213.80 | $338.84 |
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 $56.23 Median $95.50 Typical High $181.97 | Facility | 52 · Reduced service | $56.23 | $95.50 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.39 Median $38.90 Typical High $72.44 | Facility | 53 · Discontinued | $22.39 | $38.90 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $144.54 Typical High $269.15 | Facility | 54 · Surgery only | $85.11 | $144.54 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $28.84 Typical High $54.95 | Facility | 55 · Aftercare only | $16.98 | $28.84 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $19.50 Typical High $36.31 | Facility | 56 · Pre-op care only | $11.22 | $19.50 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $134.90 Typical High $251.19 | Facility | 78 · Unplanned return to OR | $79.43 | $134.90 | $251.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $95.50 Typical High $120.23 | Professional | 52 · Reduced service | $56.23 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $38.02 Typical High $47.86 | Professional | 53 · Discontinued | $22.39 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $141.25 Typical High $177.83 | Professional | 54 · Surgery only | $85.11 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $28.18 Typical High $36.31 | Professional | 55 · Aftercare only | $16.98 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $19.05 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.22 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $131.83 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $79.43 | $131.83 | $165.96 |
Where Kentucky sits
The same service costs 3.6 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 $617KY $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.