How much rates vary
Facilitymedian $174 · 10th to 90th $89 to $1,778Professionalmedian $129 · 10th to 90th $95 to $295
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 $239.88 Typical High $851.14 | Facility | None | $117.49 | $239.88 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $288.40 | Professional | None | $117.49 | $181.97 | $288.40 |
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 $95.50 Median $114.82 Typical High $162.18 | Professional | None | $95.50 | $114.82 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $162.18 Typical High $208.93 | Facility | None | $109.65 | $162.18 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $181.97 | Professional | None | $123.03 | $154.88 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $147.91 Typical High $190.55 | Facility | None | $34.67 | $147.91 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $239.88 Typical High $1,258.93 | Professional | None | $112.20 | $239.88 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $114.82 Median $208.93 Typical High $354.81 | Professional | None | $114.82 | $208.93 | $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 $58.88 Median $87.10 Typical High $123.03 | Facility | 52 · Reduced service | $58.88 | $87.10 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $48.98 | Facility | 53 · Discontinued | $23.44 | $34.67 | $48.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $181.97 | Facility | 54 · Surgery only | $87.10 | $128.82 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $36.31 | Facility | 55 · Aftercare only | $17.38 | $25.70 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $24.55 | Facility | 56 · Pre-op care only | $11.75 | $17.38 | $24.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $81.28 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $87.10 Typical High $125.89 | Professional | 52 · Reduced service | $58.88 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $50.12 | Professional | 53 · Discontinued | $23.44 | $34.67 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $190.55 | Professional | 54 · Surgery only | $87.10 | $128.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $38.02 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $177.83 |
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
$135
WI $490KY $135
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.