How much rates vary
Facilitymedian $1,318 · 10th to 90th $170 to $2,884Professionalmedian $126 · 10th to 90th $89 to $219
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 $112.20 Median $173.78 Typical High $851.14 | Facility | None | $112.20 | $173.78 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $181.97 | Professional | None | $109.65 | $151.36 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $138.04 | Professional | None | $81.28 | $100.00 | $138.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $147.91 Typical High $208.93 | Professional | 50 · Both sides | $123.03 | $147.91 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,019.95 | Facility | None | $1,584.89 | $2,041.74 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $1,348.96 Typical High $1,659.59 | Facility | None | $169.82 | $1,348.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $851.14 | Professional | None | $102.33 | $162.18 | $851.14 |
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 $95.50 Median $141.25 Typical High $218.78 | Professional | None | $95.50 | $141.25 | $218.78 |
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 $56.23 Median $75.86 Typical High $91.20 | Facility | 52 · Reduced service | $56.23 | $75.86 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $30.20 Typical High $36.31 | Facility | 53 · Discontinued | $22.91 | $30.20 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $112.20 Typical High $138.04 | Facility | 54 · Surgery only | $85.11 | $112.20 | $138.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $22.39 Typical High $27.54 | Facility | 55 · Aftercare only | $16.98 | $22.39 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $18.20 | Facility | 56 · Pre-op care only | $11.22 | $15.14 | $18.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $104.71 Typical High $128.82 | Facility | 78 · Unplanned return to OR | $79.43 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $77.62 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.90 Typical High $36.31 | Professional | 53 · Discontinued | $22.91 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $85.11 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $16.98 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.22 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $107.15 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $79.43 | $107.15 | $128.82 |
Where Kentucky sits
The same service costs 4.8 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
$126
AK $603KY $126
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.