How much rates vary
Facilitymedian $355 · 10th to 90th $174 to $1,995Professionalmedian $166 · 10th to 90th $91 to $288
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 $173.78 Median $218.78 Typical High $363.08 | Facility | None | $173.78 | $218.78 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $363.08 | Professional | None | $173.78 | $229.09 | $363.08 |
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 $91.20 Median $134.90 Typical High $199.53 | Professional | None | $91.20 | $134.90 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $263.03 Typical High $407.38 | Facility | None | $165.96 | $263.03 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $263.03 | Professional | None | $162.18 | $208.93 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $331.13 Typical High $691.83 | Facility | None | $34.67 | $331.13 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $1,737.80 | Professional | None | $154.88 | $257.04 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $39.81 | Professional | None | $33.11 | $33.11 | $39.81 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $331.13 | Professional | None | $144.54 | $213.80 | $331.13 |
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 $87.10 Median $109.65 Typical High $181.97 | Facility | 52 · Reduced service | $87.10 | $109.65 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $43.65 Typical High $72.44 | Facility | 53 · Discontinued | $34.67 | $43.65 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $165.96 Typical High $275.42 | Facility | 54 · Surgery only | $131.83 | $165.96 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $33.11 Typical High $54.95 | Facility | 55 · Aftercare only | $26.30 | $33.11 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.88 Typical High $36.31 | Facility | 56 · Pre-op care only | $17.38 | $21.88 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $154.88 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $123.03 | $154.88 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $114.82 Typical High $181.97 | Professional | 52 · Reduced service | $87.10 | $114.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $72.44 | Professional | 53 · Discontinued | $34.67 | $45.71 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $169.82 Typical High $275.42 | Professional | 54 · Surgery only | $131.83 | $169.82 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $54.95 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $36.31 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $158.49 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $123.03 | $158.49 | $257.04 |
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
$166
AK $741KY $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.