How much rates vary
Facilitymedian $209 · 10th to 90th $107 to $2,239Professionalmedian $120 · 10th to 90th $87 to $234
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 $107.15 Median $154.88 Typical High $851.14 | Facility | None | $107.15 | $154.88 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $218.78 | Professional | None | $107.15 | $154.88 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $169.82 | Professional | None | $81.28 | $100.00 | $169.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $147.91 Typical High $251.19 | Professional | 50 · Both sides | $123.03 | $147.91 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $162.18 Typical High $208.93 | Facility | None | $112.20 | $162.18 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $186.21 | Professional | None | $104.71 | $158.49 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $154.88 Typical High $204.17 | Facility | None | $34.67 | $154.88 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $933.25 | Professional | None | $117.49 | $181.97 | $933.25 |
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 $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 $107.15 Median $162.18 Typical High $263.03 | Professional | None | $107.15 | $162.18 | $263.03 |
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 $53.70 Median $77.62 Typical High $83.18 | Facility | 52 · Reduced service | $53.70 | $77.62 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $30.90 Typical High $33.88 | Facility | 53 · Discontinued | $21.88 | $30.90 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $117.49 Typical High $125.89 | Facility | 54 · Surgery only | $81.28 | $117.49 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $23.44 Typical High $25.12 | Facility | 55 · Aftercare only | $16.22 | $23.44 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.49 Typical High $16.98 | Facility | 56 · Pre-op care only | $10.72 | $15.49 | $16.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $109.65 Typical High $117.49 | Facility | 78 · Unplanned return to OR | $75.86 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $75.86 Typical High $85.11 | Professional | 52 · Reduced service | $53.70 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $30.20 Typical High $33.88 | Professional | 53 · Discontinued | $21.88 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $114.82 Typical High $125.89 | Professional | 54 · Surgery only | $81.28 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $22.91 Typical High $25.12 | Professional | 55 · Aftercare only | $16.22 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.14 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.72 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $107.15 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $75.86 | $107.15 | $117.49 |
Where Kentucky sits
The same service costs 4.1 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 $513KY $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.