How much rates vary
Facilitymedian $191 · 10th to 90th $105 to $1,862Professionalmedian $158 · 10th to 90th $112 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 $117.49 Median $177.83 Typical High $851.14 | Facility | None | $117.49 | $177.83 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $269.15 | Professional | None | $117.49 | $177.83 | $269.15 |
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 $109.65 Median $151.36 Typical High $199.53 | Professional | None | $109.65 | $151.36 | $199.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $223.87 Typical High $302.00 | Professional | 50 · Both sides | $162.18 | $223.87 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $194.98 Typical High $263.03 | Facility | None | $104.71 | $194.98 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $204.17 | Professional | None | $123.03 | $173.78 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $190.55 Typical High $691.83 | Facility | None | $34.67 | $190.55 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $1,047.13 | Professional | None | $125.89 | $208.93 | $1,047.13 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $302.00 | Professional | None | $125.89 | $194.98 | $302.00 |
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 $58.88 Median $79.43 Typical High $97.72 | Facility | 52 · Reduced service | $58.88 | $79.43 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $31.62 Typical High $38.90 | Facility | 53 · Discontinued | $23.44 | $31.62 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $120.23 Typical High $144.54 | Facility | 54 · Surgery only | $87.10 | $120.23 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $23.99 Typical High $28.84 | Facility | 55 · Aftercare only | $17.38 | $23.99 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.85 Typical High $19.50 | Facility | 56 · Pre-op care only | $11.75 | $15.85 | $19.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $112.20 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $81.28 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $87.10 Typical High $97.72 | Professional | 52 · Reduced service | $58.88 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $38.90 | Professional | 53 · Discontinued | $23.44 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $147.91 | Professional | 54 · Surgery only | $87.10 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $29.51 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $138.04 |
Where Kentucky sits
The same service costs 3.5 times more in Wisconsin 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
$162
WI $575KY $162
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.