How much rates vary
Facilitymedian $398 · 10th to 90th $117 to $3,548Professionalmedian $166 · 10th to 90th $105 to $257
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 $199.53 Typical High $851.14 | Facility | None | $117.49 | $199.53 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $295.12 | Professional | None | $117.49 | $199.53 | $295.12 |
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 $104.71 Median $165.96 Typical High $208.93 | Professional | None | $104.71 | $165.96 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $177.83 Typical High $269.15 | Facility | None | $109.65 | $177.83 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $181.97 | Professional | None | $100.00 | $154.88 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $194.98 Typical High $691.83 | Facility | None | $34.67 | $194.98 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $1,047.13 | Professional | None | $114.82 | $199.53 | $1,047.13 |
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 $141.25 Median $204.17 Typical High $323.59 | Professional | None | $141.25 | $204.17 | $323.59 |
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 $87.10 Typical High $125.89 | Facility | 52 · Reduced service | $57.54 | $87.10 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $50.12 | Facility | 53 · Discontinued | $23.44 | $34.67 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $186.21 | Facility | 54 · Surgery only | $87.10 | $128.82 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $26.30 Typical High $37.15 | Facility | 55 · Aftercare only | $17.38 | $26.30 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $25.12 | Facility | 56 · Pre-op care only | $11.75 | $17.38 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $81.28 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $87.10 Typical High $125.89 | Professional | 52 · Reduced service | $57.54 | $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 $186.21 | Professional | 54 · Surgery only | $87.10 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $26.30 Typical High $37.15 | Professional | 55 · Aftercare only | $17.38 | $26.30 | $37.15 |
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 $173.78 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $173.78 |
Where Kentucky sits
The same service costs 3.8 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
$166
WI $631KY $166
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.