How much rates vary
Facilitymedian $151 · 10th to 90th $78 to $1,862Professionalmedian $105 · 10th to 90th $78 to $178
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 $102.33 Median $134.90 Typical High $173.78 | Facility | None | $102.33 | $134.90 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $177.83 | Professional | None | $102.33 | $134.90 | $177.83 |
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 $100.00 Typical High $177.83 | Professional | None | $75.86 | $100.00 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $1,122.02 Typical High $1,995.26 | Facility | None | $97.72 | $1,122.02 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $162.18 | Professional | None | $97.72 | $138.04 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $165.96 | Facility | None | $34.67 | $75.86 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $933.25 | Professional | None | $100.00 | $144.54 | $933.25 |
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 $104.71 Median $147.91 Typical High $213.80 | Professional | None | $104.71 | $147.91 | $213.80 |
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 $51.29 Median $67.61 Typical High $87.10 | Facility | 52 · Reduced service | $51.29 | $67.61 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $35.48 | Facility | 53 · Discontinued | $20.42 | $26.92 | $35.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $75.86 Median $102.33 Typical High $131.83 | Facility | 54 · Surgery only | $75.86 | $102.33 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $20.42 Typical High $26.30 | Facility | 55 · Aftercare only | $15.14 | $20.42 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $17.38 | Facility | 56 · Pre-op care only | $10.23 | $13.49 | $17.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $95.50 Typical High $123.03 | Facility | 78 · Unplanned return to OR | $70.79 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $67.61 Typical High $74.13 | Professional | 52 · Reduced service | $51.29 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $29.51 | Professional | 53 · Discontinued | $20.42 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $102.33 Typical High $112.20 | Professional | 54 · Surgery only | $75.86 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.42 Typical High $22.39 | Professional | 55 · Aftercare only | $15.14 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $95.50 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $70.79 | $95.50 | $104.71 |
Where Kentucky sits
The same service costs 4.2 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.
Kentucky· 51st of 51
$105
AK $437KY $105
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.