How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,096 to $10,000Professionalmedian $1,380 · 10th to 90th $1,047 to $2,089
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 $1,174.90 Median $1,412.54 Typical High $1,778.28 | Facility | None | $1,174.90 | $1,412.54 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,412.54 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,318.26 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $4,897.79 | Facility | None | $1,096.48 | $1,778.28 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,548.82 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $3,630.78 | Facility | None | $1,348.96 | $2,511.89 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $7,413.10 | Professional | None | $1,148.15 | $1,659.59 | $7,413.10 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,737.80 | $2,511.89 |
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 $588.84 Median $707.95 Typical High $891.25 | Facility | 52 · Reduced service | $588.84 | $707.95 | $891.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $234.42 Median $281.84 Typical High $354.81 | Facility | 53 · Discontinued | $234.42 | $281.84 | $354.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $870.96 Median $1,047.13 Typical High $1,348.96 | Facility | 54 · Surgery only | $870.96 | $1,047.13 | $1,348.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $173.78 Median $213.80 Typical High $269.15 | Facility | 55 · Aftercare only | $173.78 | $213.80 | $269.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $117.49 Median $141.25 Typical High $177.83 | Facility | 56 · Pre-op care only | $117.49 | $141.25 | $177.83 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $977.24 Typical High $1,258.93 | Facility | 78 · Unplanned return to OR | $812.83 | $977.24 | $1,258.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $707.95 Typical High $891.25 | Professional | 52 · Reduced service | $588.84 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $281.84 Typical High $354.81 | Professional | 53 · Discontinued | $234.42 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,047.13 Typical High $1,348.96 | Professional | 54 · Surgery only | $870.96 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $173.78 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $141.25 Typical High $177.83 | Professional | 56 · Pre-op care only | $117.49 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $977.24 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $812.83 | $977.24 | $1,258.93 |
Where Kentucky sits
The same service costs 3.2 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.
Physician feeFacility fee
AK $12,311KY $3,892
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.