How much rates vary
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 $316.23 Median $389.05 Typical High $2,290.87 | Facility | None | $316.23 | $389.05 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $389.05 | Professional | None | $316.23 | $338.84 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $5,888.44 Typical High $7,244.36 | Facility | None | $812.83 | $5,888.44 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $91.20 | Professional | None | $60.26 | $70.79 | $91.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $107.15 Typical High $134.90 | Professional | 50 · Both sides | $91.20 | $107.15 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $7,943.28 Typical High $14,125.38 | Facility | None | $446.68 | $7,943.28 | $14,125.38 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $6,918.31 Typical High $12,302.69 | Professional | None | $446.68 | $6,918.31 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,570.40 Typical High $2,884.03 | Facility | None | $741.31 | $2,570.40 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $660.69 | Professional | None | $380.19 | $416.87 | $660.69 |
5 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 Professional Modifier 52 · Reduced service Typical Low $158.49 Median $169.82 Typical High $194.98 | Professional | 52 · Reduced service | $158.49 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $77.62 | Professional | 53 · Discontinued | $64.57 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $239.88 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $38.90 |
Where Kentucky sits
The same service costs 28.2 times more in Texas 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
$91.20
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.