How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $7,413Professionalmedian $468 · 10th to 90th $324 to $2,884
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 $457.09 Median $1,995.26 Typical High $2,454.71 | Facility | None | $457.09 | $1,995.26 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $1,905.46 Typical High $2,089.30 | Professional | None | $436.52 | $1,905.46 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $741.31 | Professional | None | $316.23 | $371.54 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $549.54 Typical High $1,023.29 | Professional | 50 · Both sides | $467.74 | $549.54 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $630.96 Typical High $5,011.87 | Facility | None | $398.11 | $630.96 | $5,011.87 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $660.69 | Professional | None | $389.05 | $537.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $707.95 Typical High $4,265.80 | Facility | None | $34.67 | $707.95 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,862.09 Typical High $10,000.00 | Professional | None | $407.38 | $1,862.09 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $302.00 | Professional | None | $33.11 | $33.11 | $302.00 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,819.70 Typical High $2,884.03 | Professional | None | $363.08 | $1,819.70 | $2,884.03 |
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 $223.87 Median $239.88 Typical High $1,230.27 | Facility | 52 · Reduced service | $223.87 | $239.88 | $1,230.27 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $489.78 | Facility | 53 · Discontinued | $91.20 | $95.50 | $489.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $1,862.09 | Facility | 54 · Surgery only | $338.84 | $354.81 | $1,862.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $371.54 | Facility | 55 · Aftercare only | $67.61 | $70.79 | $371.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $245.47 | Facility | 56 · Pre-op care only | $45.71 | $47.86 | $245.47 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $1,737.80 | Facility | 78 · Unplanned return to OR | $316.23 | $331.13 | $1,737.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $954.99 Typical High $1,047.13 | Professional | 52 · Reduced service | $223.87 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $380.19 Typical High $416.87 | Professional | 53 · Discontinued | $91.20 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $1,445.44 Typical High $1,548.82 | Professional | 54 · Surgery only | $338.84 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $288.40 Typical High $309.03 | Professional | 55 · Aftercare only | $67.61 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $190.55 Typical High $208.93 | Professional | 56 · Pre-op care only | $45.71 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $1,348.96 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $316.23 | $1,348.96 | $1,445.44 |
Where Kentucky sits
The same service costs 9.8 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
$501
AK $4,898KY $501
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.