How much rates vary
Facilitymedian $1,175 · 10th to 90th $141 to $3,890Professionalmedian $129 · 10th to 90th $93 to $209
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 $173.78 Typical High $416.87 | Facility | None | $117.49 | $173.78 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $245.47 | Professional | None | $117.49 | $162.18 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $208.93 | Professional | None | $131.83 | $131.83 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $186.21 | Professional | None | $91.20 | $114.82 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $165.96 Typical High $213.80 | Facility | None | $120.23 | $165.96 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $199.53 | Professional | None | $131.83 | $169.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $208.93 Typical High $1,659.59 | Facility | None | $138.04 | $208.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $933.25 | Professional | None | $125.89 | $177.83 | $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 $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 $112.20 Median $165.96 Typical High $251.19 | Professional | None | $112.20 | $165.96 | $251.19 |
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 $58.88 Median $81.28 Typical High $91.20 | Facility | 52 · Reduced service | $58.88 | $81.28 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $33.11 Typical High $37.15 | Facility | 53 · Discontinued | $23.44 | $33.11 | $37.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $123.03 Typical High $138.04 | Facility | 54 · Surgery only | $89.13 | $123.03 | $138.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $24.55 Typical High $27.54 | Facility | 55 · Aftercare only | $17.78 | $24.55 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.22 Typical High $18.62 | Facility | 56 · Pre-op care only | $11.75 | $16.22 | $18.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $114.82 Typical High $128.82 | Facility | 78 · Unplanned return to OR | $83.18 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $79.43 Typical High $91.20 | Professional | 52 · Reduced service | $58.88 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $23.44 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $120.23 Typical High $138.04 | Professional | 54 · Surgery only | $89.13 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.99 Typical High $27.54 | Professional | 55 · Aftercare only | $17.78 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.75 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $112.20 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $83.18 | $112.20 | $128.82 |
Where Kentucky sits
The same service costs 3.9 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
$141
AK $550KY $141
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.