How much rates vary
Facilitymedian $1,660 · 10th to 90th $240 to $7,244Professionalmedian $204 · 10th to 90th $155 to $347
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 $190.55 Median $239.88 Typical High $794.33 | Facility | None | $190.55 | $239.88 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $295.12 | Professional | None | $190.55 | $239.88 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $288.40 | Professional | None | $147.91 | $181.97 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $1,659.59 | Facility | None | $190.55 | $309.03 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $323.59 | Professional | None | $177.83 | $275.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,288.25 Typical High $1,862.09 | Facility | None | $331.13 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $1,380.38 | Professional | None | $199.53 | $263.03 | $1,380.38 |
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 $190.55 Median $288.40 Typical High $426.58 | Professional | None | $190.55 | $288.40 | $426.58 |
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 $95.50 Median $120.23 Typical High $134.90 | Facility | 52 · Reduced service | $95.50 | $120.23 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $47.86 Typical High $53.70 | Facility | 53 · Discontinued | $38.02 | $47.86 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $181.97 Typical High $204.17 | Facility | 54 · Surgery only | $141.25 | $181.97 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $36.31 Typical High $40.74 | Facility | 55 · Aftercare only | $28.18 | $36.31 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $26.92 | Facility | 56 · Pre-op care only | $19.05 | $23.99 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $169.82 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $131.83 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $95.50 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $53.70 | Professional | 53 · Discontinued | $38.02 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $141.25 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $165.96 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $131.83 | $165.96 | $190.55 |
Where Kentucky sits
The same service costs 4.7 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
$214
AK $1,000KY $214
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.