How much rates vary
Facilitymedian $1,862 · 10th to 90th $537 to $7,244Professionalmedian $513 · 10th to 90th $372 to $832
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 $407.38 Median $549.54 Typical High $794.33 | Facility | None | $407.38 | $549.54 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $602.56 | Professional | None | $407.38 | $537.03 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $707.95 | Professional | None | $371.54 | $512.86 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $776.25 Typical High $1,023.29 | Professional | 50 · Both sides | $562.34 | $776.25 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $2,344.23 | Facility | None | $363.08 | $691.83 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $707.95 | Professional | None | $436.52 | $602.56 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,659.59 Typical High $2,290.87 | Facility | None | $562.34 | $1,659.59 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $3,162.28 | Professional | None | $446.68 | $676.08 | $3,162.28 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $977.24 | Professional | None | $436.52 | $588.84 | $977.24 |
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 $204.17 Median $245.47 Typical High $302.00 | Facility | 52 · Reduced service | $204.17 | $245.47 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $120.23 | Facility | 53 · Discontinued | $81.28 | $97.72 | $120.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $309.03 Median $363.08 Typical High $446.68 | Facility | 54 · Surgery only | $309.03 | $363.08 | $446.68 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $72.44 Typical High $89.13 | Facility | 55 · Aftercare only | $61.66 | $72.44 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $60.26 | Facility | 56 · Pre-op care only | $40.74 | $48.98 | $60.26 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $338.84 Typical High $416.87 | Facility | 78 · Unplanned return to OR | $288.40 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $204.17 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $81.28 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $309.03 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $61.66 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $40.74 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $288.40 | $380.19 | $416.87 |
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
$562
AK $2,291KY $562
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.