How much rates vary
Facilitymedian $1,202 · 10th to 90th $209 to $3,802Professionalmedian $209 · 10th to 90th $148 to $316
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 $158.49 Median $208.93 Typical High $851.14 | Facility | None | $158.49 | $208.93 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $245.47 | Professional | None | $158.49 | $208.93 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $4,265.80 | Facility | None | $707.95 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $234.42 | Professional | None | $147.91 | $177.83 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $812.83 | Facility | None | $173.78 | $281.84 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $281.84 | Professional | None | $173.78 | $234.42 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $549.54 Typical High $1,659.59 | Facility | None | $323.59 | $549.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $1,548.82 | Professional | None | $181.97 | $257.04 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $112.20 | Professional | None | $33.11 | $33.11 | $112.20 |
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 $190.55 Median $263.03 Typical High $346.74 | Professional | None | $190.55 | $263.03 | $346.74 |
13 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 $79.43 Median $104.71 Typical High $147.91 | Facility | 52 · Reduced service | $79.43 | $104.71 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $41.69 Typical High $58.88 | Facility | 53 · Discontinued | $32.36 | $41.69 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $158.49 Typical High $218.78 | Facility | 54 · Surgery only | $120.23 | $158.49 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $31.62 Typical High $43.65 | Facility | 55 · Aftercare only | $23.99 | $31.62 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.89 Typical High $29.51 | Facility | 56 · Pre-op care only | $15.85 | $20.89 | $29.51 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $147.91 Typical High $204.17 | Facility | 78 · Unplanned return to OR | $112.20 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $79.43 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $120.23 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $23.99 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.85 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $112.20 | $147.91 | $169.82 |
Ambetter Setting Professional Modifier 51 · Multiple procedures + 59 · Distinct service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 51 · Multiple procedures + 59 · Distinct service | $269.15 | $269.15 | $269.15 |
Where Kentucky sits
The same service costs 4.3 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 $912KY $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.