How much rates vary
Facilitymedian $1,175 · 10th to 90th $138 to $3,890Professionalmedian $93 · 10th to 90th $68 to $263
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 $100.00 Median $234.42 Typical High $851.14 | Facility | None | $100.00 | $234.42 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $218.78 Typical High $239.88 | Professional | None | $97.72 | $218.78 | $239.88 |
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 $67.61 Median $79.43 Typical High $109.65 | Professional | None | $67.61 | $79.43 | $109.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $120.23 Typical High $154.88 | Professional | 50 · Both sides | $100.00 | $120.23 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $138.04 Typical High $323.59 | Facility | None | $74.13 | $138.04 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $144.54 | Professional | None | $95.50 | $123.03 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $213.80 Typical High $398.11 | Facility | None | $34.67 | $213.80 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $213.80 Typical High $1,995.26 | Professional | None | $89.13 | $213.80 | $1,995.26 |
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 $85.11 Median $186.21 Typical High $295.12 | Professional | None | $85.11 | $186.21 | $295.12 |
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 $50.12 Median $114.82 Typical High $186.21 | Facility | 52 · Reduced service | $50.12 | $114.82 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $46.77 Typical High $74.13 | Facility | 53 · Discontinued | $19.95 | $46.77 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $173.78 Typical High $275.42 | Facility | 54 · Surgery only | $74.13 | $173.78 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $34.67 Typical High $56.23 | Facility | 55 · Aftercare only | $14.79 | $34.67 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $23.44 Typical High $37.15 | Facility | 56 · Pre-op care only | $10.00 | $23.44 | $37.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $162.18 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $69.18 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $112.20 Typical High $120.23 | Professional | 52 · Reduced service | $50.12 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $44.67 Typical High $48.98 | Professional | 53 · Discontinued | $19.95 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $74.13 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $33.88 Typical High $36.31 | Professional | 55 · Aftercare only | $14.79 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $22.39 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.00 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $158.49 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $69.18 | $158.49 | $169.82 |
Where Kentucky sits
The same service costs 5.6 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
$100
AK $562KY $100
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.