How much rates vary
Facilitymedian $191 · 10th to 90th $89 to $1,148Professionalmedian $110 · 10th to 90th $78 to $269
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 $114.82 Median $190.55 Typical High $371.54 | Facility | None | $114.82 | $190.55 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $295.12 | Professional | None | $114.82 | $190.55 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $75.86 Median $89.13 Typical High $134.90 | Professional | None | $75.86 | $89.13 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $524.81 Typical High $933.25 | Facility | None | $107.15 | $524.81 | $933.25 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $177.83 | Professional | None | $107.15 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $194.98 | Facility | None | $34.67 | $75.86 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $1,023.29 | Professional | None | $112.20 | $190.55 | $1,023.29 |
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 $120.23 Median $194.98 Typical High $309.03 | Professional | None | $120.23 | $194.98 | $309.03 |
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 $57.54 Median $79.43 Typical High $95.50 | Facility | 52 · Reduced service | $57.54 | $79.43 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $31.62 Typical High $38.02 | Facility | 53 · Discontinued | $22.91 | $31.62 | $38.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $117.49 Typical High $144.54 | Facility | 54 · Surgery only | $85.11 | $117.49 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $23.44 Typical High $28.84 | Facility | 55 · Aftercare only | $16.98 | $23.44 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.85 Typical High $19.05 | Facility | 56 · Pre-op care only | $11.48 | $15.85 | $19.05 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $109.65 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $79.43 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $79.43 Typical High $100.00 | Professional | 52 · Reduced service | $57.54 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $31.62 Typical High $39.81 | Professional | 53 · Discontinued | $22.91 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $117.49 Typical High $151.36 | Professional | 54 · Surgery only | $85.11 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.44 Typical High $30.20 | Professional | 55 · Aftercare only | $16.98 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.85 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.48 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $109.65 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $79.43 | $109.65 | $141.25 |
Where Kentucky sits
The same service costs 4.5 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
$112
AK $501KY $112
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.