How much rates vary
Facilitymedian $170 · 10th to 90th $87 to $1,778Professionalmedian $95 · 10th to 90th $72 to $219
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 $104.71 Median $169.82 Typical High $851.14 | Facility | None | $104.71 | $169.82 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $204.17 | Professional | None | $104.71 | $162.18 | $204.17 |
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 $70.79 Median $83.18 Typical High $134.90 | Professional | None | $70.79 | $83.18 | $134.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $125.89 Typical High $199.53 | Professional | 50 · Both sides | $107.15 | $125.89 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $208.93 | Facility | None | $100.00 | $162.18 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $165.96 | Professional | None | $91.20 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $147.91 Typical High $173.78 | Facility | None | $34.67 | $147.91 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $912.01 | Professional | None | $102.33 | $169.82 | $912.01 |
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 $102.33 Median $169.82 Typical High $281.84 | Professional | None | $102.33 | $169.82 | $281.84 |
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 $52.48 Median $77.62 Typical High $85.11 | Facility | 52 · Reduced service | $52.48 | $77.62 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $30.90 Typical High $34.67 | Facility | 53 · Discontinued | $20.89 | $30.90 | $34.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $114.82 Typical High $128.82 | Facility | 54 · Surgery only | $79.43 | $114.82 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $23.44 Typical High $25.70 | Facility | 55 · Aftercare only | $15.85 | $23.44 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.49 Typical High $17.38 | Facility | 56 · Pre-op care only | $10.47 | $15.49 | $17.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $107.15 Typical High $120.23 | Facility | 78 · Unplanned return to OR | $74.13 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $52.48 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $20.89 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $114.82 Typical High $134.90 | Professional | 54 · Surgery only | $79.43 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $15.85 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.47 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $107.15 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $74.13 | $107.15 | $125.89 |
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
$102
AK $457KY $102
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.