How much rates vary
Facilitymedian $178 · 10th to 90th $98 to $2,754Professionalmedian $89 · 10th to 90th $69 to $182
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 $97.72 Median $141.25 Typical High $141.25 | Facility | None | $97.72 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $151.36 | Professional | None | $97.72 | $138.04 | $151.36 |
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 $67.61 Median $79.43 Typical High $125.89 | Professional | None | $67.61 | $79.43 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $138.04 Typical High $177.83 | Facility | None | $93.33 | $138.04 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $154.88 | Professional | None | $91.20 | $131.83 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $134.90 Typical High $398.11 | Facility | None | $34.67 | $134.90 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $758.58 | Professional | None | $95.50 | $147.91 | $758.58 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $229.09 | Professional | None | $97.72 | $141.25 | $229.09 |
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 $48.98 Median $70.79 Typical High $70.79 | Facility | 52 · Reduced service | $48.98 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $28.18 Typical High $28.18 | Facility | 53 · Discontinued | $19.50 | $28.18 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $104.71 Typical High $107.15 | Facility | 54 · Surgery only | $74.13 | $104.71 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $20.89 Typical High $21.38 | Facility | 55 · Aftercare only | $14.79 | $20.89 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.13 Typical High $14.13 | Facility | 56 · Pre-op care only | $9.77 | $14.13 | $14.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $97.72 Typical High $100.00 | Facility | 78 · Unplanned return to OR | $69.18 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $69.18 Typical High $74.13 | Professional | 52 · Reduced service | $48.98 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $27.54 Typical High $29.51 | Professional | 53 · Discontinued | $19.50 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $104.71 Typical High $112.20 | Professional | 54 · Surgery only | $74.13 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $14.79 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.80 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.77 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $97.72 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $69.18 | $97.72 | $104.71 |
Where Kentucky sits
The same service costs 4.4 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
$95.50
AK $417KY $95.50
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.